Emily Michelle Hagman, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.016797 Issued in IL

Practice address

3400 W New Leaf LN
Peoria, IL 61615

Phone

(309) 589-1011

Fax

(309) 589-1019

NPI assigned

Aug 31, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1314748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536278400000",
    "number": "1427339779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 FAYETTE ST",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616033610",
            "telephone_number": "309-671-8020",
            "fax_number": "309-671-8007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 W NEW LEAF LN",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "61615",
            "telephone_number": "309-589-1011",
            "fax_number": "309-589-1019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGMAN",
        "first_name": "EMILY",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-31",
        "last_updated": "2018-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.016797",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1639231731",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lindsey Habecker
• Gretchen Joy Hackett, CRNA
• Allison Leigh Hadra, MS, CCC-SLP
• John W Hafner, M.D.
• Kathleen Jo Hagenauer, APN
• James R Haig, LCSW
• Samantha Haikal
• Tesfu Hailu, MD
• Jennifer Anne Pizinger Haines, O.T.
• Alaa Hajeissa, MD

• Clinical Social Worker in Peoria, IL
• Providers in Peoria, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2018; 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.