Provider Demographics
NPI:1073342820
Name:HANSEN, CALLIE LYNEA (MS, MA, LPC)
Entity type:Individual
Prefix:
First Name:CALLIE
Middle Name:LYNEA
Last Name:HANSEN
Suffix:
Gender:F
Credentials:MS, MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8660 KINZIE JOS WAY
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-9010
Mailing Address - Country:US
Mailing Address - Phone:785-323-7600
Mailing Address - Fax:
Practice Address - Street 1:4201 ANDERSON AVE
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66503-7602
Practice Address - Country:US
Practice Address - Phone:785-539-5455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-30
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLPC04752101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health