Samuel Jacob Hansen | Murray, UT • PECOS Search

Samuel Jacob Hansen

Social Worker

Behavioral Health & Social Service Providers

5965 S 900 E, Murray, UT 84121-1757

(801) 639-9146 (801) 867-5170

PECOS Enrollment

Based on the most recent information from CMS, provider Samuel Jacob Hansen does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1518559814
Provider Type
Individual
Full Name
Hansen, Samuel Jacob
Gender
Male

Sole Proprietor
No
Enumeration Date
2/8/2021
Last Updated
3/7/2025

Contact Information

Practice Location

5965 S 900 E, Murray, UT 84121-1757

Unlisted Fax

Mailing Location

5676 S Magic Dr, Murray, UT 84107-8220

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License 7477111-3501 Utah