Individual provider Active NPI

Haylie Hirner, LMSW

  • Clinical Social Worker
  • Bettendorf, IA
National Provider Identifier
1467190652
Registry record updated May 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
112700 Issued in IA
Practice address
3625 Utica Ridge Rd Ste F
Bettendorf, IA 52722-1653
Phone
(563) 359-6750
NPI assigned
May 26, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2022

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 112700 IA Primary

Addresses

Primary practice location

3625 Utica Ridge Rd Ste F
Bettendorf, IA 52722-1653

Mailing address

5745 N Brady St Apt 105
Davenport, IA 52806-2269

Other identifiers 1

IdentifierTypeStateIssuer
26-4372219MedicaidIA

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL https://lifeconnections.kasa-solutions.com/index.php Health Information Exchange (HIE)

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
112700IAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Life Connection, L.C. CurrentSince May 29, 2022 Accepting new patients

Locations

3625 Utica Ridge Rd
Ste F
Bettendorf, IA 52722
Phone (563) 293-6575

Organizations & group practices 1

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": "1653523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653523200000",
    "number": "1467190652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5745 N BRADY ST APT 105",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528062269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3625 UTICA RIDGE RD STE F",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527221653",
            "telephone_number": "563-359-6750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIRNER",
        "first_name": "HAYLIE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-26",
        "last_updated": "2022-05-26",
        "certification_date": "2022-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "112700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "26-4372219",
            "state": "IA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://lifeconnections.kasa-solutions.com/index.php",
            "affiliation": "N",
            "endpointDescription": "EHR System - Kasa Practice Solutions",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "EHR",
            "address_1": "215 4th Ave SE",
            "city": "Cedar Rapids",
            "state": "IA",
            "country_code": "US",
            "postal_code": "524011844",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bettendorf, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2022; 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.