Provider Demographics
NPI:1053712406
Name:WILLIAM J. HANSHAW, LMFT
Entity type:Organization
Organization Name:WILLIAM J. HANSHAW, LMFT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LMFT / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:HANSHAW
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:270-782-7156
Mailing Address - Street 1:1209 SMALLHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42104-3263
Mailing Address - Country:US
Mailing Address - Phone:270-782-7156
Mailing Address - Fax:270-782-7156
Practice Address - Street 1:1209 SMALLHOUSE RD
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42104-3263
Practice Address - Country:US
Practice Address - Phone:270-782-7156
Practice Address - Fax:270-782-7156
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-04
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLPC0000000029101YP2500X
KYKY-0132106H00000X
TNLMT0000000094106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100266430Medicaid