Individual provider Active NPI

Leah Hanson, LPC

  • Mental Health Counselor
  • De Queen, AR
National Provider Identifier
1023337730
Registry record updated Apr 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
P1503013 Issued in AR
Practice address
304 W Collin Raye Dr Ste 103a
De Queen, AR 71832-2000
Phone
(870) 330-4460
Fax
(870) 330-4460
NPI assigned
May 19, 2010
Last updated
Apr 25, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 10-10AE-PL AR
Mental Health Counselor 101YM0800X A1107064 AR
Mental Health Counselor 101YM0800X P1503013 AR Primary
Case Manager/Care Coordinator 171M00000X NU

Addresses

Primary practice location

304 W Collin Raye Dr Ste 103a
De Queen, AR 71832-2000

Mailing address

1015 E 35TH St
Texarkana, AR 71854-2745
Phone (870) 330-4460

Other practice location 1

1015 E 35th St
Texarkana, AR 71854-2745
Phone (870) 330-4460

Other identifiers 1

IdentifierTypeStateIssuer
116399726MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240206001558 AR Practitioner - Mental Health Counselor 7618338492 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Transitions Counseling Clinic PLCGroup PAC ID 7416318399, 2 clinicians

Practice addresses (Care Compare)

304 W Collin Raye Dr
Suite 103a
De Queen, AR 71832-2000
Phone (870) 200-9294

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10-10AE-PLARMDCounselor
A1107064ARMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Chenal Family Therapy, PLC Mental Health CurrentSince Oct 9, 2022 Accepting new patients
Transitions Counseling Clinic PLC Counselor CurrentSince Jan 1, 2024 Accepting new patients

Locations

304 W Collin Raye Dr
Ste 103A
De Queen, AR 71832
Phone (870) 200-9294

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1274227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682380800000",
    "number": "1023337730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 E 35TH ST",
            "city": "TEXARKANA",
            "state": "AR",
            "postal_code": "718542745",
            "telephone_number": "870-330-4460",
            "fax_number": "870-330-4460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 W COLLIN RAYE DR STE 103A",
            "city": "DE QUEEN",
            "state": "AR",
            "postal_code": "718322000",
            "telephone_number": "870-330-4460",
            "fax_number": "870-330-4460"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1015 E 35th St",
            "address_purpose": "LOCATION",
            "city": "Texarkana",
            "state": "AR",
            "postal_code": "718542745",
            "country_code": "US",
            "telephone_number": "870-330-4460",
            "fax_number": "870-330-4460",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HANSON",
        "first_name": "LEAH",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-19",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "AR",
            "license": "10-10AE-PL",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AR",
            "license": "A1107064",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AR",
            "license": "P1503013",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116399726",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in De Queen, AR

Sources for this page

Verify at the official NPI Registry.