Amy L Hansen, L.C.P.C.

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180.008016 Issued in IL

Practice address

2900 W Heading Ave
West Peoria, IL 61604-4868

Phone

(309) 636-7601

Fax

(309) 671-0253

NPI assigned

Dec 7, 2011

Last updated

Dec 7, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1323216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323216000000",
    "number": "1043588874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 W ALEXANDER ST",
            "city": "MORTON",
            "state": "IL",
            "postal_code": "615501510",
            "telephone_number": "309-310-2613",
            "fax_number": "309-671-0253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 W HEADING AVE",
            "city": "WEST PEORIA",
            "state": "IL",
            "postal_code": "616044868",
            "telephone_number": "309-636-7601",
            "fax_number": "309-671-0253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSEN",
        "first_name": "AMY",
        "middle_name": "L",
        "credential": "L.C.P.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-07",
        "last_updated": "2011-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.008016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in West Peoria, IL
• Providers in West Peoria, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.