Individual
MR. ANDREW KENNETH HANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SUDP
Contact information
Practice address
6541 SPECKER AVE # 1830, FORT CARSON, CO 80913-4263
(719) 526-7155
Mailing address
6541 SPECKER AVE # 1830, FORT CARSON, CO 80913-4263
(719) 526-7155
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP60557542
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1467925370
TRICARE
CO
05
—
2077844
—
WA
Enumeration date
01/03/2019
Last updated
04/01/2026
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