Mark Andrew Hansen, LPCC 15352

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

15352 Issued in CA

Practice address

1470 Bluegrass LN
Tracy, CA 95377-9245

Phone

(925) 209-8546

NPI assigned

Oct 10, 2013

Last updated

Dec 27, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Mr. Mark Andrew Hansen Professional name

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": "1381363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703635200000",
    "number": "1225465156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1470 BLUEGRASS LN",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953779245",
            "telephone_number": "925-209-8546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1470 BLUEGRASS LN",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953779245",
            "telephone_number": "925-209-8546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSEN",
        "first_name": "MARK",
        "middle_name": "ANDREW",
        "name_prefix": "Mr.",
        "credential": "LPCC 15352",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-10-10",
        "last_updated": "2023-12-27",
        "certification_date": "2023-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "H1012021917",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "15352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARK",
            "last_name": "HANSEN",
            "middle_name": "ANDREW",
            "prefix": "MR.",
            "credential": "LPCC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Kelly Hand
• Taylor Hanes
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• Aaron Hans Hansen, RN
• Sydney Bree Hansen, MS, RD
• Garth Howland Harley Jr., MD
• Harold K Reich's Pharmacy (Reich's Medical Supply)
• Moirah Harper
• Jaliyah Harrison

• Professional Counselor in Tracy, CA
• Providers in Tracy, CA by specialty
• Professional Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2023; 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.