Provider Demographics
NPI:1194070607
Name:HANSEN, DANIELLA ELISE (LCP-MHSP, NCC, MED)
Entity type:Individual
Prefix:
First Name:DANIELLA
Middle Name:ELISE
Last Name:HANSEN
Suffix:
Gender:F
Credentials:LCP-MHSP, NCC, MED
Other - Prefix:
Other - First Name:DANIELLA
Other - Middle Name:ELISE
Other - Last Name:RASTRELLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2400 WHITE AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37204-2235
Mailing Address - Country:US
Mailing Address - Phone:615-460-4240
Mailing Address - Fax:
Practice Address - Street 1:2400 WHITE AVE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37204-2235
Practice Address - Country:US
Practice Address - Phone:615-460-4240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-20
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
TN3347101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health