Dr. Mark Sullivan Hanson
Clinical Psychologist
130 Centre St Wadsworth Village, Hathorne House #4
Danvers
, Massachusetts 01923-1400
Dr. Mark Sullivan Hanson
Clinical Psychologist
130 Centre St Wadsworth Village, Hathorne House #4
Danvers
, Massachusetts 01923-1400
(978) 777-3883
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About
Features
Specialties
- Clinical Psychologist
Languages spoken
- English
Location
First Address
- Dr. Mark Sullivan Hanson
- 130 Centre St School House 101a
- Danvers, MA
- Zip : 01923-1400
- Fax : (978) 777-3883
- Phone : (978) 777-1088
Second Address
- Dr. Mark Sullivan Hanson
- 130 Centre St Wadsworth Village, Hathorne House #4
- Danvers, MA
- Zip : 01923-1400
- Fax : (978) 777-3883
- Phone : (978) 777-1088
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 103G00000X | Clinical Psychologist | 6390 | MA |
| Y | 103TC0700X | Clinical Psychologist | 6390 | MA |
National Provider Identifier
| NPI | 1003984386 |
|---|---|
| Provider Name | Dr. Mark Sullivan Hanson |
| First Address | Danvers, MA 01923-1400 |
| Second Address | Danvers, MA 01923-1400 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 02/12/2006 |
| Last Update Date | 24/05/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| W06514 | BLUE CROSS BLUE SHIELD (01) | MA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.