| Hansen Therapy, Llc | |
|
2717 N Grandview Blvd Suite 110 Waukesha WI 53188-1672 | |
| (414) 303-4205 | |
| Not Available |
| Full Name | Hansen Therapy, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 2717 N Grandview Blvd, Waukesha, Wisconsin |
| Authorized Official Name and Position | Peter John Hansen (LICENSED PSYCHOLOGIST/OWNER) |
| Authorized Official Contact | 4143034205 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hansen Therapy, Llc 2717 N Grandview Blvd Suite 110 Waukesha WI 53188-1672 Ph: (414) 303-4205 | Hansen Therapy, Llc 2717 N Grandview Blvd Suite 110 Waukesha WI 53188-1672 Ph: (414) 303-4205 |
| NPI Number | 1093805095 |
|---|---|
| Provider Enumeration Date | 10/13/2006 |
| Last Update Date | 06/20/2013 |
| Medicare PECOS PAC ID | 7113957804 |
|---|---|
| Medicare Enrollment ID | O20050812000391 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093805095 | NPI | - | NPPES |
| 391-305-00 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC1900X | Psychologist - Counseling | 2072-057 (Wisconsin) | Primary |
| Provider Name | Peter J Hansen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1619067600 PECOS PAC ID: 7012820814 Enrollment ID: I20031107000450 |
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