Katie Hagen, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

7758-123 Issued in WI

Practice address

1717 Taylor Avenue
Racine, WI 53403

Phone

(262) 224-5224

NPI assigned

Jun 3, 2011

Last updated

May 18, 2015By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Metropolitan Charities IncGroup PAC ID 2163668286, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network

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.

• Metropolitan Charities Inc

  dba Metro Healthy Communities

  • Federally Qualified Health Center (FQHC)
  • St Petersburg, FL
  • NPI 1013277060
  Medicare reassignment Care Compare group NPD
• Innovative Recovery Network of Wisconsin LLC

  dba Innovative Recovery

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Milwaukee, WI
  • NPI 1427332501
  NPD (past)

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

{
    "created_epoch": "1307059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431907200000",
    "number": "1720372022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9256 W ALLERTON AVE",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532282706",
            "telephone_number": "262-224-5224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 TAYLOR AVENUE",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "53403",
            "telephone_number": "262-224-5224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGEN",
        "first_name": "KATIE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-03",
        "last_updated": "2015-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW12025",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "7758-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abbey Lynn Gwinnup, LCSW
• Megan Renee Haapanen, PHARMD
• Konrad Joeseph Haase
• Candice Ann Hackbarth, M.S., CCC-SLP
• Regina Marlene Hadley, CSAC
• Rebecca Hamilton, RPH
• Sheryl Ann Hamilton, M.S.
• Jennifer E Hammack
• Lisa Hammel, PHARMD
• Marissa Lynn Hammernik, M.S

• Clinical Social Worker in Racine, WI
• Providers in Racine, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.