Provider Demographics
NPI:1871621912
Name:HANSEN, RENEE LAVAUN (MS LPC)
Entity type:Individual
Prefix:MS
First Name:RENEE
Middle Name:LAVAUN
Last Name:HANSEN
Suffix:
Gender:F
Credentials:MS LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 E 17TH ST
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82001-4608
Mailing Address - Country:US
Mailing Address - Phone:307-631-9931
Mailing Address - Fax:307-635-7706
Practice Address - Street 1:300 E 17TH ST
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-4608
Practice Address - Country:US
Practice Address - Phone:307-631-9931
Practice Address - Fax:307-635-7706
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYLPC-514101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional