Individual provider Active NPI

Jeffrey Michael Hansen, LMSW

  • Social Worker
  • Spartanburg, SC
National Provider Identifier
1639405541
Registry record updated Oct 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
9018 Issued in SC
Practice address
250 Dewey Ave
Spartanburg, SC 29303-3009
Phone
(864) 585-0366
Fax
(864) 583-3136
NPI assigned
Oct 28, 2009
Last updated
Oct 28, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 9018 SC Primary

Addresses

Primary practice location

250 Dewey Ave
Spartanburg, SC 29303-3009

Mailing address

250 Dewey Ave
Spartanburg, SC 29303-3009
Phone (864) 585-0366

Other identifiers 1

IdentifierTypeStateIssuer
121328MedicaidSC

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1256688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256688000000",
    "number": "1639405541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 DEWEY AVE",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293033009",
            "telephone_number": "864-585-0366",
            "fax_number": "864-583-3136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 DEWEY AVE",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293033009",
            "telephone_number": "864-585-0366",
            "fax_number": "864-583-3136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSEN",
        "first_name": "JEFFREY",
        "middle_name": "MICHAEL",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-28",
        "last_updated": "2009-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "SC",
            "license": "9018",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "121328",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2009; 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.