Active NPI
Brian Hansen, PH.D.
- Clinical Psychologist
- Provo, UT
National Provider Identifier
1497068910
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 8918949-2501
- Practice address
- 125 East 300 South Suite 207
Provo, UT 84606-5156 - Phone
- (801) 477-6940
- NPI assigned
- Jul 26, 2010
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 8918949-2501 | UT | Primary |
Addresses
Primary practice location
125 East 300 South Suite 207
Provo, UT 84606-5156
Mailing address
993 East 300 South
Provo, UT 84606-5156
Phone (801) 310-2133
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 |
|---|---|---|---|
| 8918949-2501 | UT | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1280102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1472774400000",
"number": "1497068910",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "993 EAST 300 SOUTH",
"city": "PROVO",
"state": "UT",
"postal_code": "846065156",
"telephone_number": "801-310-2133"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "125 EAST 300 SOUTH SUITE 207",
"city": "PROVO",
"state": "UT",
"postal_code": "846065156",
"telephone_number": "801-477-6940"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANSEN",
"first_name": "BRIAN",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-07-26",
"last_updated": "2016-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "UT",
"license": "8918949-2501",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Provo, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.