Leslie A Hagedorn, LSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

99073814A Issued in IN

Practice address

734 W Delaware St Ste 217
Evansville, IN 47710-1667

Phone

(812) 499-7950

NPI assigned

Nov 5, 2016

Last updated

Nov 5, 2016By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Safe Haven LLC

  dba Genesis Health & Wellness Center

  • Community/Behavioral Health Agency
  • Evansville, IN
  • NPI 1164925772
  NPD (past)

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

{
    "created_epoch": "1478304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478304000000",
    "number": "1710429907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5618 JEFFERSON AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477155018",
            "telephone_number": "812-568-1282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "734 W DELAWARE ST STE 217",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477101667",
            "telephone_number": "812-499-7950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGEDORN",
        "first_name": "LESLIE",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "LSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-05",
        "last_updated": "2016-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IN",
            "license": "99073814A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jane L Hackert
• Kassie Hackleman
• Lotfi Hadad, M.D.
• Christina Marie Hagan, LCSW
• Jennifer L Hagan, CST
• Michael G Hagedorn, LCAC
• Diane Hagler, LSW
• David Kent Hahn, RPH
• Sara J Hahn, NP
• Timothy A Haire, H.I.S.

• Social Worker in Evansville, IN
• Providers in Evansville, IN by specialty
• Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2016; 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.