Active NPI
Sandra Jean Hanson, LADC
- Addiction (Substance Use Disorder) Counselor
- Moorhead, MN
National Provider Identifier
1376083576
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 300070
- Practice address
- 111 7TH St S
Moorhead, MN 56560-2738 - Phone
- (218) 287-2089
- Fax
- (218) 291-1250
- NPI assigned
- Mar 7, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 300070 | MN | Primary |
Addresses
Primary practice location
111 7TH St S
Moorhead, MN 56560-2738
Mailing address
111 7TH St S
Moorhead, MN 56560-2738
Phone (218) 287-2089
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 |
|---|---|---|---|
| 300070 | MN | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Trinity Lutheran Church | Past | Accepting new patients | |
| Lost & Found Recovery Center | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Community/Behavioral Health Agency
- Moorhead, MN
- NPI 1588100739
-
- Mental Health Counselor
- Moorhead, MN
- NPI 1841672227
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1488844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1488844800000",
"number": "1376083576",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 7TH ST S",
"city": "MOORHEAD",
"state": "MN",
"postal_code": "565602738",
"telephone_number": "218-287-2089",
"fax_number": "218-291-1250"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 7TH ST S",
"city": "MOORHEAD",
"state": "MN",
"postal_code": "565602738",
"telephone_number": "218-287-2089",
"fax_number": "218-291-1250"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANSON",
"first_name": "SANDRA",
"middle_name": "JEAN",
"credential": "LADC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-03-07",
"last_updated": "2017-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MN",
"license": "300070",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moorhead, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.