Provider Demographics
NPI:1447535661
Name:HANSEN, SHARLA R (MSW, LMSW)
Entity type:Individual
Prefix:MS
First Name:SHARLA
Middle Name:R
Last Name:HANSEN
Suffix:
Gender:F
Credentials:MSW, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 S CEDAR ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48910-4676
Mailing Address - Country:US
Mailing Address - Phone:517-887-2762
Mailing Address - Fax:517-887-2982
Practice Address - Street 1:3400 S CEDAR ST
Practice Address - Street 2:SUITE 201
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48910-4676
Practice Address - Country:US
Practice Address - Phone:517-887-2762
Practice Address - Fax:517-887-2982
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-19
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010809411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical