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NPI Code Detail

MEDICARE: MR. ROBERT ALLEN HANSEN M.ED., PCC-S

MEDICARE: MR. ROBERT ALLEN HANSEN M.ED., PCC-S
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselorE4318OH
2101YM0800XMental Health Counselor
3101YA0400XAddiction (Substance Use Disorder) Counselor
4101YP2500XProfessional Counselor

General Provider Information

NPI Number : 1275624116
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ROBERT ALLEN HANSEN M.ED., PCC-S
Provider Business Mailing Address
First Line : 2801 C CT
Second Line :
City : ASHTABULA
State : OH
Zip : 44004-4577
Country : US
Telephone Number : 440-998-4210
Fax Number : 440-998-6775
Provider Business Practice Location Address
First Line : 2801 C CT
Second Line :
City : ASHTABULA
State : OH
Zip : 44004-4577
Country : US
Telephone Number : 440-998-4210
Fax Number : 440-998-6775
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2006
Last Update Date : 09/11/2025

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