Provider Demographics
NPI:1861624447
Name:HANSON, PATRICIA ANN (LICSW)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:ANN
Last Name:HANSON
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:100 BURRILL ST
Mailing Address - Street 2:UNIT 3
Mailing Address - City:SWAMPSCOTT
Mailing Address - State:MA
Mailing Address - Zip Code:01907-1980
Mailing Address - Country:US
Mailing Address - Phone:781-462-8877
Mailing Address - Fax:978-854-6907
Practice Address - Street 1:7 ESSEX GREEN DR
Practice Address - Street 2:SUITE 63
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-2961
Practice Address - Country:US
Practice Address - Phone:781-462-8877
Practice Address - Fax:978-854-6907
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-17
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1132461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical