Provider Demographics
NPI:1205566395
Name:HANSON, LAURA ANN (CLINICAL SOC WORKER)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:ANN
Last Name:HANSON
Suffix:
Gender:F
Credentials:CLINICAL SOC WORKER
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:ANN
Other - Last Name:SANFILLIPO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CLINICAL SOC WORKER
Mailing Address - Street 1:4107 BEALL ST
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20784-2623
Mailing Address - Country:US
Mailing Address - Phone:724-994-0184
Mailing Address - Fax:
Practice Address - Street 1:4107 BEALL ST
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20784-2623
Practice Address - Country:US
Practice Address - Phone:724-994-0184
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-13
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD28459OtherSTATE LCSWC
VA0904014056OtherSTATE LCSW
PACW019190OtherSTATE LCSW
DCLC50081478OtherSTATE LICSW