Rebecca Hansen, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP3796 Issued in ID

Practice address

1001 N 7TH Ave Ste 280
Pocatello, ID 83201-5788

Phone

(208) 239-1490

NPI assigned

Jun 30, 2022

Last updated

Sep 26, 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

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.

• Pocatello Hospital LLC

  dba Portneuf Medical Center

  • Psychiatric Hospital Unit
  • Pocatello, ID
  • NPI 1295777274
  NPD (past)

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

{
    "created_epoch": "1656547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727308800000",
    "number": "1366174989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 N 7TH AVE STE 280",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832015788",
            "telephone_number": "208-239-1490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 N 7TH AVE STE 280",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832015788",
            "telephone_number": "208-239-1490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSEN",
        "first_name": "REBECCA",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-30",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ID",
            "license": "SLP3796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hands on Diagnostics of Idaho, PLLC (Superior Physical Therapy)
• Brooks Bastian Hanks, LPC, MCOUN.
• Brian Hansen, DO
• Jessica Hansen
• Kyley Korynn Hansen
• Stephen M Hansen, M.D.
• Tracie Lyn Hansen, B.S.
• Kyle Hanson, LPC
• Karon A Hapke, LMSW
• Dominic Haragos, MD

• Speech-Language Pathologist in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Speech-Language Pathologist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.