Provider Demographics
NPI:1427613439
Name:HANES, LANCE MIKHAEL (CDCS)
Entity type:Individual
Prefix:
First Name:LANCE
Middle Name:MIKHAEL
Last Name:HANES
Suffix:
Gender:M
Credentials:CDCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3149 MOUNTAIN VIEW DR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99501-3106
Mailing Address - Country:US
Mailing Address - Phone:907-793-3203
Mailing Address - Fax:
Practice Address - Street 1:3149 MOUNTAIN VIEW DR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99501-3106
Practice Address - Country:US
Practice Address - Phone:907-793-3200
Practice Address - Fax:907-793-3250
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-06
Last Update Date:2025-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK4298101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)