Individual ProviderStacia HansonCounselorBehavioral Health & Social Service ProvidersPractice Address3410 Old Forest Rd, Lynchburg, VA 24501-2915(434) 455-5342PECOS EnrollmentBased on the most recent information from CMS, provider Stacia Hanson is legally eligible to order and refer claims for DME services only.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 7 days ago.Profile DetailsProvider ID1609380690Provider TypeIndividualFull NameHanson, StaciaGenderFemaleSole ProprietorNoEnumeration Date11/29/2017Last Updated11/29/2017Contact InformationPractice LocationPractice Address3410 Old Forest Rd, Lynchburg, VA 24501-2915Phone(434) 455-5342FaxUnlisted FaxMailing LocationMailing Address3410 Old Forest Rd, Lynchburg, VA 24501-2915PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101YP2500XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicense0701006903Virginia