Provider Demographics
NPI:1285806240
Name:HANSEN, CAROLYN JANET (LCSW-C)
Entity type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:JANET
Last Name:HANSEN
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8836 BAY AVE.
Mailing Address - Street 2:P.O. BOX 25
Mailing Address - City:NORTH BEACH
Mailing Address - State:MD
Mailing Address - Zip Code:20714-0025
Mailing Address - Country:US
Mailing Address - Phone:301-625-8414
Mailing Address - Fax:202-315-3417
Practice Address - Street 1:4400 E WEST HWY
Practice Address - Street 2:SUITE 28
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-4524
Practice Address - Country:US
Practice Address - Phone:301-986-1479
Practice Address - Fax:301-986-7805
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-31
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD065001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical