Individual provider Active NPI

Carol M Hansen, MFT

  • Mental Health Counselor
  • Los Angeles, CA
National Provider Identifier
1669507836
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MFT34133 Issued in CA
Practice address
11911 San Vicente Blvd
280
Los Angeles, CA 90049-5086
Phone
(310) 280-8400
Fax
(310) 476-4685
NPI assigned
Feb 21, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MFT34133 CA Primary

Addresses

Primary practice location

11911 San Vicente Blvd
280
Los Angeles, CA 90049-5086

Mailing address

390 S Sepulveda Blvd
307
Los Angeles, CA 90049-3100
Phone (310) 476-4685

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20240401001624 CA Practitioner - Marriage and Family Therapist 8729426440 Practice locations: San Dimas, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MFT34133CAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669507836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 S SEPULVEDA BLVD",
            "address_2": "307",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900493100",
            "telephone_number": "310-476-4685",
            "fax_number": "310-476-4685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11911 SAN VICENTE BLVD",
            "address_2": "280",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900495086",
            "telephone_number": "310-280-8400",
            "fax_number": "310-476-4685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSEN",
        "first_name": "CAROL",
        "middle_name": "M",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "MFT34133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.