Provider Demographics
NPI:1699552323
Name:HANSON, JESSICA CHERIE (LCSW)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:CHERIE
Last Name:HANSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 17702
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59808-7702
Mailing Address - Country:US
Mailing Address - Phone:406-381-5531
Mailing Address - Fax:
Practice Address - Street 1:2721 CONNERY WAY
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59808-1951
Practice Address - Country:US
Practice Address - Phone:406-381-5531
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-14
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-SWLC-LIC-645001041C0700X
MTBBH-LCSW-LIC-797881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical