Provider Demographics
NPI:1902970395
Name:HANSON, JILL M (LMFT, LMHC)
Entity Type:Individual
Prefix:MS
First Name:JILL
Middle Name:M
Last Name:HANSON
Suffix:
Gender:F
Credentials:LMFT, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 MOUNTAIN BRIAR
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06013-1818
Mailing Address - Country:US
Mailing Address - Phone:860-673-8848
Mailing Address - Fax:
Practice Address - Street 1:13 MOUNTAIN BRIAR
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:CT
Practice Address - Zip Code:06013-1818
Practice Address - Country:US
Practice Address - Phone:860-673-8848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5983101YM0800X
CT000520106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health