Rebekah R Hage, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW61437904 Issued in WA

Practice address

18516 101St Ave NE Ste 4
Bothell, WA 98011-3874

Phone

(425) 264-4245

NPI assigned

Feb 11, 2011

Last updated

Mar 29, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Apr 1, 2024 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Opal Mental Wellness PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Woodinville, WA
  • NPI 1417803966

  Clinical

  NPD Authorized official
• Avera McKennan

  dba Avera Gregory Hospital

  • Critical Access Hospital
  • Gregory, SD
  • NPI 1275562027
  NPD (past)

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

{
    "created_epoch": "1297382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711670400000",
    "number": "1063719912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18516 101ST AVE NE STE 4",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980113874",
            "telephone_number": "425-264-4245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18516 101ST AVE NE STE 4",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980113874",
            "telephone_number": "425-264-4245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGE",
        "first_name": "REBEKAH",
        "middle_name": "R",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-11",
        "last_updated": "2024-03-29",
        "certification_date": "2024-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW61437904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Molly Sords Ha, DPT
• Ana Haberman
• Kailyn Nycol Haberman, MSW, LSWAIC
• Sofya Hadley
• Lori Lee Haener
• Sara Haggard, BA
• Bradi Haggett
• Jessica M Haight
• Amanda Joy Hainer
• Cheryl Green Hajek, M.D.

• Clinical Social Worker in Bothell, WA
• Providers in Bothell, 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 Mar 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.