Provider Demographics
NPI:1295519049
Name:HANSON-CORCORAN, KRISTIN ANNE (LPC-IT)
Entity type:Individual
Prefix:MS
First Name:KRISTIN
Middle Name:ANNE
Last Name:HANSON-CORCORAN
Suffix:
Gender:F
Credentials:LPC-IT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7549 S 72ND ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53132-9751
Mailing Address - Country:US
Mailing Address - Phone:414-331-2664
Mailing Address - Fax:
Practice Address - Street 1:N91W17194 APPLETON AVE
Practice Address - Street 2:
Practice Address - City:MENOMONEE FALLS
Practice Address - State:WI
Practice Address - Zip Code:53051-2027
Practice Address - Country:US
Practice Address - Phone:414-235-7549
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-22
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7580-226101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional