Rebecca Ahnsdotter

Individual provider Active NPI Clinical Social Worker · Salem, OR

NPI 1962075168 · NPPES record last updated Apr 28, 2023

Key facts

NPI
1962075168
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
Practice address
1335 Cannon St SE
Salem, OR 97302-2589
Phone
(503) 805-9067
NPI assigned
Jul 23, 2021
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Breaking Free, LLC Past
since Jul 1, 2021
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Yes

Addresses

Primary practice location

1335 Cannon St SE
Salem, OR 97302-2589

Mailing address

1335 Cannon St SE
Salem, OR 97302-2589
Phone (503) 805-9067

Other providers in Salem, OR

All providers in Salem, OR · Clinical Social Worker in Oregon

Sources for this page

Verify at the official NPI Registry.