Active NPI
Liberty Ann Hanson, M.S., CCC-SLP
- Speech-Language Pathologist
- Flagstaff, AZ
National Provider Identifier
1871662783
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SLP1864
- Practice address
- 1805 W Heavenly CT
Flagstaff, AZ 86001-2836 - Phone
- (928) 779-0796
- Fax
- (928) 774-4697
- NPI assigned
- Nov 7, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SLP1864 | AZ | Primary |
Addresses
Primary practice location
1805 W Heavenly CT
Flagstaff, AZ 86001-2836
Mailing address
1805 W Heavenly CT
Flagstaff, AZ 86001-2836
Phone (928) 779-0796
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
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SLP1864 | AZ | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1234742400000",
"number": "1871662783",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1805 W HEAVENLY CT",
"city": "FLAGSTAFF",
"state": "AZ",
"postal_code": "860012836",
"telephone_number": "928-779-0796",
"fax_number": "928-774-4697"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1805 W HEAVENLY CT",
"city": "FLAGSTAFF",
"state": "AZ",
"postal_code": "860012836",
"telephone_number": "928-779-0796",
"fax_number": "928-774-4697"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANSON",
"first_name": "LIBERTY",
"middle_name": "ANN",
"credential": "M.S., CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-07",
"last_updated": "2009-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "AZ",
"license": "SLP1864",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Flagstaff, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 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.