Provider Demographics
NPI:1427469931
Name:HANSON ASSOCIATES, LLC
Entity type:Organization
Organization Name:HANSON ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:HANSON-KAHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-329-4663
Mailing Address - Street 1:4849 MILL BROOK DR
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30338-4905
Mailing Address - Country:US
Mailing Address - Phone:770-329-4663
Mailing Address - Fax:
Practice Address - Street 1:3850 HOLCOMB BRIDGE RD STE 230
Practice Address - Street 2:STE 230, SPALDING WOODS
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30092-5240
Practice Address - Country:US
Practice Address - Phone:404-846-7603
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-19
Last Update Date:2014-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC00002476101YP2500X
106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
11739388OtherCAQH
GA401384226DMedicaid
1376678839OtherINDIVIDUAL NPI