Shontrice D Hansen

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

P1812157 Issued in AR

Practice address

4001 Commercial Center Dr Ste 2
Marion, AR 72364

Phone

(870) 732-7920

NPI assigned

Aug 20, 2017

Last updated

May 16, 2019By 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

Practice roles

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.

• Mending Minds Counseling and Consultation, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • West Memphis, AR
  • NPI 1013637271
  NPD Authorized official
• Ascent Acquisitions Corp-PSC

  dba Pediatric Specialty Care

  • Counselor
  • West Memphis, AR
  • NPI 1861525826
  NPD (past)

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

{
    "created_epoch": "1503187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557964800000",
    "number": "1104342278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4001 COMMERCIAL CENTER DR STE 2",
            "city": "MARION",
            "state": "AR",
            "postal_code": "723649616",
            "telephone_number": "870-732-7920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 COMMERCIAL CENTER DR STE 2",
            "city": "MARION",
            "state": "AR",
            "postal_code": "72364",
            "telephone_number": "870-732-7920"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "413 W Tyler Ave",
            "address_purpose": "LOCATION",
            "city": "West Memphis",
            "state": "AR",
            "postal_code": "723014149",
            "country_code": "US",
            "telephone_number": "870-733-1200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HANSEN",
        "first_name": "SHONTRICE",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-20",
        "last_updated": "2019-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AR",
            "license": "P1812157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hair Jenetix LLC
• Ashley Danielle Haliburton, LMSW
• Martha Hall
• Gladys Hampton
• Brandon Hanmer
• Nathan Lee Haralson, ATC/L, CDA
• Patrice Hardin, MHPP
• Kayla Harrell
• Bernetta Harris, MHPP
• Ernest Harris

• Professional Counselor in Marion, AR
• Providers in Marion, AR by specialty
• Professional Counselor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2019; 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.