Individual provider Active NPI

Rebekah Heaton, LCSW

  • Clinical Social Worker
  • Poplar Bluff, MO
National Provider Identifier
1164065017
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2022030029 Issued in MO
Practice address
3001 Warrior LN
Poplar Bluff, MO 63901-8685
Phone
(573) 686-1200
NPI assigned
Oct 23, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2022030029 MO Primary

Addresses

Primary practice location

3001 Warrior LN
Poplar Bluff, MO 63901-8685

Mailing address

3001 Warrior LN
Poplar Bluff, MO 63901-8685
Phone (573) 686-1200

Other names 1

  • Rebekah Clubb Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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

Enrollment IDStateProvider typePAC IDDetails
I20220817003833 MO Practitioner - Clinical Social Worker 2466835863 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Counseling Center IncGroup PAC ID 2163410481, 39 clinicians

Practice addresses (Care Compare)

3001 Warrior LN
Poplar Bluff, MO 63901-8685
Phone (573) 686-1200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Family Counseling Center, Inc. CurrentSince Jul 28, 2022 Accepting new patients
Family Counseling Center, Inc. CurrentSince Jul 28, 2022 Accepting new patients

Locations

315 E Walnut St
Ellington, MO 63638
Phone (573) 663-2500

5 Sugar Creek Rd
Piedmont, MO 63957
Phone (573) 223-4169

3001 Warrior Ln
Poplar Bluff, MO 63901
Phone (573) 785-7453

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1571788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1164065017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 WARRIOR LN",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639018685",
            "telephone_number": "573-686-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 WARRIOR LN",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639018685",
            "telephone_number": "573-686-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEATON",
        "first_name": "REBEKAH",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-23",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2022030029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBEKAH",
            "last_name": "CLUBB",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Poplar Bluff, MO

Sources for this page

Verify at the official NPI Registry.