Individual provider Active NPI

Raylene Hesselberg, LICSW

  • Clinical Social Worker
  • Washington, DC
National Provider Identifier
1386836047
Registry record updated Aug 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC50078573 Issued in DC
Practice address
3020 14TH St NW
Washington, DC 20010-4336
Phone
(202) 745-4300
Fax
(202) 232-0723
NPI assigned
Aug 15, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Clinical Social Worker 1041C0700X LC50078573 DC Primary

Addresses

Primary practice location

3020 14TH St NW
Washington, DC 20010-4336

Mailing address

1220 12TH St SE
Suite 120
Washington, DC 20003-3733
Phone (202) 715-7900

Other identifiers 1

IdentifierTypeStateIssuer
024905300MedicaidDC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1187136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281398400000",
    "number": "1386836047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 12TH ST SE",
            "address_2": "SUITE 120",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200033733",
            "telephone_number": "202-715-7900",
            "fax_number": "202-544-3783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3020 14TH ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200104336",
            "telephone_number": "202-745-4300",
            "fax_number": "202-232-0723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HESSELBERG",
        "first_name": "RAYLENE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-15",
        "last_updated": "2010-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC50078573",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "024905300",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2010; 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.