Active NPI
Gary D Hanson, LMFT
- Marriage & Family Therapist
- Maple Grove, MN
National Provider Identifier
1215927066
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 1241
- Practice address
- 7200 Hemlock LN N Suite 108
Maple Grove, MN 55369-5576 - Phone
- (763) 533-5339
- Fax
- (763) 390-0862
- NPI assigned
- Oct 24, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 1241 | MN | Primary |
Addresses
Primary practice location
7200 Hemlock LN N Suite 108
Maple Grove, MN 55369-5576
Mailing address
7200 Hemlock LN N Suite 108
Maple Grove, MN 55369-5576
Phone (763) 533-5339
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1241 | Other | MN | LMFT LICENSE NUMBER |
| 697608500 | Medicaid | MN | |
| 107643 | Other | MN | HEALTH PART ID NUMBER |
| 62-90571 | Other | MN | MEDICA ID NUMBER |
| 337M8HA | Other | MN | BCBS MN PROVIDER ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1241 | MN | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hanson Associates LLC | Marriage & Family Therapist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Marriage & Family Therapist
- Maple Grove, MN
- NPI 1093787368
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130112000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1414368000000",
"number": "1215927066",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7200 HEMLOCK LN N SUITE 108",
"city": "MAPLE GROVE",
"state": "MN",
"postal_code": "553695576",
"telephone_number": "763-533-5339",
"fax_number": "763-390-0863"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7200 HEMLOCK LN N SUITE 108",
"city": "MAPLE GROVE",
"state": "MN",
"postal_code": "553695576",
"telephone_number": "763-533-5339",
"fax_number": "763-390-0862"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANSON",
"first_name": "GARY",
"middle_name": "D",
"name_prefix": "Mr.",
"credential": "LMFT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-24",
"last_updated": "2014-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "MN",
"license": "1241",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LMFT LICENSE NUMBER",
"identifier": "1241",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "697608500",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PART ID NUMBER",
"identifier": "107643",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA ID NUMBER",
"identifier": "62-90571",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS MN PROVIDER ID",
"identifier": "337M8HA",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Maple Grove, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.