Provider Demographics
NPI:1932098720
Name:HANSON, PATRICK JAMES
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:JAMES
Last Name:HANSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:891 PARKVIEW PL W
Mailing Address - Street 2:
Mailing Address - City:FERNANDINA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32034-4633
Mailing Address - Country:US
Mailing Address - Phone:973-274-5667
Mailing Address - Fax:
Practice Address - Street 1:891 PARKVIEW PL W
Practice Address - Street 2:
Practice Address - City:FERNANDINA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32034-4633
Practice Address - Country:US
Practice Address - Phone:973-274-5667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-28
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical