Provider Demographics
NPI:1053370999
Name:HANSHAW, WILLIAM ALBERT (LCSW,ACSW)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:ALBERT
Last Name:HANSHAW
Suffix:
Gender:M
Credentials:LCSW,ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 N LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47408-3447
Mailing Address - Country:US
Mailing Address - Phone:812-333-2263
Mailing Address - Fax:
Practice Address - Street 1:711 N LINCOLN ST
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47408-3447
Practice Address - Country:US
Practice Address - Phone:812-333-2263
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-20
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN3400193A101YM0800X
IN34001493A1041C0700X, 101Y00000X, 101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000343217OtherANTHEM
000000343217OtherANTHEM