Individual provider Active NPI

Rebecca Lynne Hanke, MA, LMFT

  • Marriage & Family Therapist
  • Green Bay, WI
National Provider Identifier
1699195693
Registry record updated Jan 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
1000-124 Issued in WI
Practice address
1263 Main St Ste 122
Green Bay, WI 54302-1341
Phone
(920) 393-9303
NPI assigned
Apr 17, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 2582 MN
Marriage & Family Therapist 106H00000X 1000-124 WI Primary

Addresses

Primary practice location

1263 Main St Ste 122
Green Bay, WI 54302-1341

Mailing address

1263 Main St Ste 122
Green Bay, WI 54302-1341
Phone (920) 393-9303

Other identifiers 1

IdentifierTypeStateIssuer
1134457047MedicaidWI

Other names 1

  • Rebecca Lynne Beall Former name

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
1000-124WIMDMarriage & Family Therapist
2582MNMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1397692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578528000000",
    "number": "1699195693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1263 MAIN ST STE 122",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543021341",
            "telephone_number": "920-393-9303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1263 MAIN ST STE 122",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543021341",
            "telephone_number": "920-393-9303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANKE",
        "first_name": "REBECCA",
        "middle_name": "LYNNE",
        "credential": "MA, LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-17",
        "last_updated": "2020-01-09",
        "certification_date": "2020-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "2582",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WI",
            "license": "1000-124",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1134457047",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "BEALL",
            "middle_name": "LYNNE",
            "credential": "MA, LMFT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2020; 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.