Provider Demographics
NPI:1760219208
Name:HANSEN, ERIN RENEE (LCSWA)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:RENEE
Last Name:HANSEN
Suffix:
Gender:
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5109 BUR OAK CIR STE 103
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-3101
Mailing Address - Country:US
Mailing Address - Phone:208-869-1676
Mailing Address - Fax:
Practice Address - Street 1:5109 BUR OAK CIR STE 103
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-3101
Practice Address - Country:US
Practice Address - Phone:919-275-1405
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-18
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0205481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical