MEDICARE: RIKKI HANSON LCSW

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
1	1041C0700X	Clinical Social Worker	CSW.09927075	CO

General Provider Information

NPI Number	:	1922690080
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RIKKI HANSON LCSW

Provider Business Mailing Address
First Line	:	98 WADSWORTH BLVD UNIT 1277099
Second Line	:
City	:	LAKEWOOD
State	:	CO
Zip	:	80226-1550
Country	:	US
Telephone Number	:	720-443-3511
Fax Number	:

Provider Business Practice Location Address
First Line	:	2732 S BRAUN WAY
Second Line	:
City	:	LAKEWOOD
State	:	CO
Zip	:	80228-4954
Country	:	US
Telephone Number	:	303-919-7379
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/09/2021
Last Update Date	:	02/09/2021

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