Individual provider Active NPI

Denise Joan Hanson, PSY.D.

  • Clinical Psychologist
  • Wilmington, NC
National Provider Identifier
1649258583
Registry record updated Nov 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2572 Issued in NC
Practice address
4415 Grey Oaks CT
Wilmington, NC 28412-2543
Phone
(910) 352-4657
NPI assigned
Dec 31, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 7260 MA
Clinical Psychologist 103TC0700X 2572 NC Primary

Addresses

Primary practice location

4415 Grey Oaks CT
Wilmington, NC 28412-2543

Mailing address

4415 Grey Oaks CT
Wilmington, NC 28412-2543
Phone (910) 352-4657

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051025001007 NC Practitioner - Clinical Psychologist 2567489990 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1515 Medical Ctr Dr
Wilmington, NC 28401-7507
Phone (910) 352-4657

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2572NCMDClinical Psychologist
7260MAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Hanson Psychological Clinical CurrentSince Feb 4, 2022 Accepting new patients
Center for Integrated Health Care Past Accepting new patients

Locations

4000 Shipyard Blvd
Ste 100
Wilmington, NC 28403
Phone (910) 792-5570

1515 Medical Center Dr
Wilmington, NC 28401
Phone (910) 352-4657

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.

NPI Registry JSON

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

{
    "created_epoch": "1135987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667433600000",
    "number": "1649258583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4415 GREY OAKS CT",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284122543",
            "telephone_number": "910-352-4657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4415 GREY OAKS CT",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284122543",
            "telephone_number": "910-352-4657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSON",
        "first_name": "DENISE",
        "middle_name": "JOAN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-31",
        "last_updated": "2022-11-03",
        "certification_date": "2022-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "7260",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "2572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.