Individual provider Active NPI

Roselyne Hazard-Schillebeeckx, LCSW

  • Clinical Social Worker
  • Union, MO
National Provider Identifier
1689723397
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2004024133 Issued in MO
Practice address
126 W Main St.
2ND Floor W
Union, MO 63084
Phone
(636) 583-9863
Fax
(636) 583-6648
NPI assigned
Jan 10, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 2004024133 MO Primary

Addresses

Primary practice location

126 W Main St.
2ND Floor W
Union, MO 63084

Mailing address

640 Honey Locust LN
Labadie, MO 63055-1068
Phone (636) 742-6901

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
2004024133MOMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689723397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 HONEY LOCUST LN",
            "city": "LABADIE",
            "state": "MO",
            "postal_code": "630551068",
            "telephone_number": "636-742-6901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 W MAIN ST.",
            "address_2": "2ND FLOOR W",
            "city": "UNION",
            "state": "MO",
            "postal_code": "63084",
            "telephone_number": "636-583-9863",
            "fax_number": "636-583-6648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAZARD-SCHILLEBEECKX",
        "first_name": "ROSELYNE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2004024133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Union, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.