Rebecca Connie Pedersen, LICSW,SUDP,LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

365936-3501 Issued in UT

Practice address

802 E Bamberger Dr Ste a
American Fork, UT 84003-2179

Phone

(801) 633-9887

NPI assigned

May 14, 2015

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

Other names 1

• Rebecca Connie Webb Former name

Medicare fee-for-service enrollment

Enrolled in UT

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

Specialty

Clinical Social Worker

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Ascendant Behavioral Health LLCGroup PAC ID 1850673187, 62 clinicians

Practice addresses (Care Compare)

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.

• Ascendant Behavioral Health LLC

  dba Ascendant Behavioral Health DBA LifeStance

  • Clinical Social Worker
  • Murray, UT
  • NPI 1689128605
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1431561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1386022978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "802 E BAMBERGER DR STE A",
            "city": "AMERICAN FORK",
            "state": "UT",
            "postal_code": "840032179",
            "telephone_number": "801-633-9887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 E BAMBERGER DR STE A",
            "city": "AMERICAN FORK",
            "state": "UT",
            "postal_code": "840032179",
            "telephone_number": "801-633-9887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDERSEN",
        "first_name": "REBECCA",
        "middle_name": "CONNIE",
        "name_prefix": "Mrs.",
        "credential": "LICSW,SUDP,LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-14",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP60818488",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW61089331",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "365936-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "WEBB",
            "middle_name": "CONNIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Toby Paulson, D.O.
• Paul A. Paxman, OD
• Katelyn Pead, AMFT
• Peak Orthodontics PLLC
• Shannon Peck, PA-C
• Krista K Pendleton, RN
• Peoplefirst Homecare & Hospice of Utah, LLC (Hearts for Hospice)
• Peoplefirst Homecare & Hospice of Utah, LLC (Hearts for Home Health)
• Erin P Perez
• Adam Perkins, OTD

• Clinical Social Worker in American Fork, UT
• Providers in American Fork, UT by specialty
• Clinical Social Worker in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.