Kenneth Hansen
Individual provider Active NPI Social Worker · Wakefield, MI
NPI 1417445982 · NPPES record last updated Apr 30, 2018
Key facts
- NPI
- 1417445982
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 6802070571 (MI)
- Practice address
- 103 W US Highway 2
Wakefield, MI 49968-9515 - Phone
- (906) 229-6120
- Fax
- (906) 229-6191
- NPI assigned
- Apr 30, 2018
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6802070571 | MI | MD | Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 6802070571 | MI | Yes |
Addresses
Primary practice location
103 W US Highway 2
Wakefield, MI 49968-9515
Mailing address
103 W US Highway 2
Wakefield, MI 49968-9515
Phone (906) 229-6120
Other providers in Wakefield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 30, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.