Raeann Hagen, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

22189 Issued in MN

Practice address

150 10TH St NW Ste 2
Milaca, MN 56353-1737

Phone

(320) 272-5051

NPI assigned

Feb 12, 2017

Last updated

Oct 12, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Raeann Byram Other name

Medicare fee-for-service enrollment

Enrolled in MN

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Lighthouse Child & Family Services

  • Community/Behavioral Health Agency
  • Foley, MN
  • NPI 1689861197
  Medicare reassignment NPD
• Awakened Connections Therapy

  • Clinical Social Worker
  • Milaca, MN
  • NPI 1205632346
  NPD (past)

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

{
    "created_epoch": "1486857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697068800000",
    "number": "1881133718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 10TH ST NW STE 2",
            "city": "MILACA",
            "state": "MN",
            "postal_code": "563531737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 10TH ST NW STE 2",
            "city": "MILACA",
            "state": "MN",
            "postal_code": "563531737",
            "telephone_number": "320-272-5051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGEN",
        "first_name": "RAEANN",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-12",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "22189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RAEANN",
            "last_name": "BYRAM",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Deborah Hannah Gault, LICSW
• George B Gerstenkorn, MD
• Elisabeth Ann Gliddon, LMFT
• Jennifer Jean Goerger, LICSW
• Kelsey Ann Gruba, LMFT
• Julie Ann Hanenburg, LICSW
• Nancy Hansmeier, OTR/L, CLT
• Hobert Drugs Inc (Frank Pharmacy)
• Peter Thompson Hoffman, MS, LP
• Home Advantage Health Care LLC

• Clinical Social Worker in Milaca, MN
• Providers in Milaca, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.