Keli Hagen Lisw, PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

KELI HAGEN LISW, PLLC

Doing business as

Keli Hagen Sole MBR

Practice address

4403 1St Ave SE Ste 412
Cedar Rapids, IA 52402-3221

Phone

(319) 213-2922

NPI assigned

Aug 19, 2020

Last updated

Aug 19, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Keli B Hagen, LISWNPI 1497211007

Title

Sole Member

Phone

(319) 213-2922

Specialties & licenses 1

Addresses

Other names 1

• Keli Hagen Sole MBR Doing business as

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Keli Bea Hagen

  • Clinical Social Worker
  • Cedar Rapids, IA
  • NPI 1497211007
  Medicare reassignment Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1597795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597795200000",
    "number": "1013529114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4403 1ST AVE SE STE 412",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524023221",
            "telephone_number": "319-213-2922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4403 1ST AVE SE STE 412",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524023221",
            "telephone_number": "319-213-2922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELI HAGEN LISW, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-19",
        "last_updated": "2020-08-19",
        "certification_date": "2020-08-19",
        "status": "A",
        "authorized_official_last_name": "HAGEN",
        "authorized_official_first_name": "KELI",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "319-213-2922",
        "authorized_official_credential": "LISW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Keli Hagen Sole MBR",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jami Lynn Keeton
• Cassandra Kehoe
• Louis Charles Keiler III, M.D.
• Stephanie Keiper
• Alyce Keith, BSN, PMH-BC
• Claire Kellen
• Kelly Marie Kellen, DC
• Shannon Marie Keller
• Liv Kelley-Sellnau, ARNP FNP-BC PMHNP-BC
• Abbie Leann Kelley, RN, MSN, PMHNP-BC

• Clinical Social Worker in Cedar Rapids, IA
• Providers in Cedar Rapids, IA by specialty
• Clinical Social Worker in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.