Active NPI
Anthony Wayne Hansen, PHD
- Counseling Psychologist
- Smyrna, GA
National Provider Identifier
1821720822
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- PSY004330
- Practice address
- 3995 W Cooper Lake Dr SE
Smyrna, GA 30082-4006 - Phone
- (404) 889-6886
- NPI assigned
- Jun 28, 2022
- 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 |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | PSY004330 | GA | Primary |
Addresses
Primary practice location
3995 W Cooper Lake Dr SE
Smyrna, GA 30082-4006
Mailing address
3995 W Cooper Lake Dr SE
Smyrna, GA 30082-4006
Phone (404) 358-3200
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 |
|---|---|---|---|
| PSY004330 | GA | MD | Counseling Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1656374400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656374400000",
"number": "1821720822",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3995 W COOPER LAKE DR SE",
"city": "SMYRNA",
"state": "GA",
"postal_code": "300824006",
"telephone_number": "404-358-3200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3995 W COOPER LAKE DR SE",
"city": "SMYRNA",
"state": "GA",
"postal_code": "300824006",
"telephone_number": "404-889-6886"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANSEN",
"first_name": "ANTHONY",
"middle_name": "WAYNE",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-06-28",
"last_updated": "2022-06-28",
"certification_date": "2022-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "GA",
"license": "PSY004330",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Smyrna, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.