Mark P Hansen, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

LP 1440 Issued in MN

Practice address

1360 Energy Park Dr
Suite 340
Saint Paul, MN 55108-5276

Phone

(651) 646-8985

Fax

(651) 646-3959

NPI assigned

Dec 7, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Counseling Psychologists of Woodbury, P.a.

  • Psychologist
  • Woodbury, MN
  • NPI 1659301398
  NPD

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

{
    "created_epoch": "1133913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222214400000",
    "number": "1972588473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1360 ENERGY PARK DR",
            "address_2": "SUITE 340",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551085276",
            "telephone_number": "651-646-8985",
            "fax_number": "651-646-3959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 ENERGY PARK DR",
            "address_2": "SUITE 340",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551085276",
            "telephone_number": "651-646-8985",
            "fax_number": "651-646-3959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSEN",
        "first_name": "MARK",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-07",
        "last_updated": "2008-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MN",
            "license": "LP 1440",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP 1440",
            "primary": true
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "MN",
            "license": "LP 1440",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS& BLUE SHEILD",
            "identifier": "42GI3HA",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "01009904",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "643353700",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeanne Renee Hansen
• Jeffrey James Hansen, PSYD
• Jill Hansen
• John Martin Hansen, LP
• Jordan Hansen, LADC
• Payton Ann Hansen
• Rachel Ruth Hansen, MD
• Shelly A Hansen, CNNP
• Samuel Vaughan Hanson Willis, M.D.
• Amy Hanson

• Psychologist in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2008; 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.