Active NPI
Blake Darrell Hansen, PHD
- Behavior Analyst
- Pleasant Grove, UT
National Provider Identifier
1306350186
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 11235836-2506
- Practice address
- 1609 W 50 N
Pleasant Grove, UT 84062-3565 - Phone
- (801) 419-5899
- NPI assigned
- Nov 30, 2017
- 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 |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 11235836-2506 | UT | Primary |
Addresses
Primary practice location
1609 W 50 N
Pleasant Grove, UT 84062-3565
Mailing address
1609 W 50 N
Pleasant Grove, UT 84062-3565
Phone (801) 419-5899
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11235836-2506 | UT | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1512000000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611187200000",
"number": "1306350186",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1609 W 50 N",
"city": "PLEASANT GROVE",
"state": "UT",
"postal_code": "840623565",
"telephone_number": "801-419-5899"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1609 W 50 N",
"city": "PLEASANT GROVE",
"state": "UT",
"postal_code": "840623565",
"telephone_number": "801-419-5899"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANSEN",
"first_name": "BLAKE",
"middle_name": "DARRELL",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-11-30",
"last_updated": "2021-01-21",
"certification_date": "2021-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "UT",
"license": "11235836-2506",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pleasant Grove, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.