Provider Demographics
NPI:1609603638
Name:HANSON, LINDA POLANSKY (LPC)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:POLANSKY
Last Name:HANSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 HILLSIDE VISTA DR
Mailing Address - Street 2:
Mailing Address - City:PINE GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:17963-1165
Mailing Address - Country:US
Mailing Address - Phone:570-292-0165
Mailing Address - Fax:
Practice Address - Street 1:396 S CENTRE ST STE 3
Practice Address - Street 2:
Practice Address - City:POTTSVILLE
Practice Address - State:PA
Practice Address - Zip Code:17901-3597
Practice Address - Country:US
Practice Address - Phone:570-990-5078
Practice Address - Fax:570-516-9344
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-16
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC017590101YA0400X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health