Rebekah E Verdugo, LICSW, LCSW, SUDP

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW61271858 Issued in WA

Practice address

1924 NW Russell St
Poulsbo, WA 98370-9518

Phone

(775) 544-5065

NPI assigned

Oct 10, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lightheart Associates PS

  • Psychologist
  • Redmond, WA
  • NPI 1609221720

  Clinical

  Medicare reassignment NPD
• Dr. Kathleen Worsley

  • Counseling Psychologist
  • Redmond, WA
  • NPI 1619484821
  NPD (past)

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

{
    "created_epoch": "1476057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707782400000",
    "number": "1023568490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1924 NW RUSSELL ST",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983709518",
            "telephone_number": "775-544-5065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1924 NW RUSSELL ST",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983709518",
            "telephone_number": "775-544-5065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERDUGO",
        "first_name": "REBEKAH",
        "middle_name": "E",
        "credential": "LICSW, LCSW, SUDP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-10",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW61271858",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP61261902",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "9046-C",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catelyn Tweeten, AU.D.
• Heather Ullrich
• Ultimate Performance Rehabilitation LLC
• Ruth Urand
• James A Van, PA-C
• Vintage Direct Primary Care
• Virginia E Swanson MD PLLC
• Shannon Foster Vitone
• Matthew A Voorsanger, MD
• Wagner Family Wellness Center LLC

• Clinical Social Worker in Poulsbo, WA
• Providers in Poulsbo, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.