Provider Demographics
NPI:1023899937
Name:HESSE, REBEKAH SUZANNE (LCSW)
Entity type:Individual
Prefix:
First Name:REBEKAH
Middle Name:SUZANNE
Last Name:HESSE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5241 GREEN BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:MD
Mailing Address - Zip Code:21036-1203
Mailing Address - Country:US
Mailing Address - Phone:219-973-7878
Mailing Address - Fax:
Practice Address - Street 1:5241 GREEN BRIDGE RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:MD
Practice Address - Zip Code:21036-1203
Practice Address - Country:US
Practice Address - Phone:219-973-7878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-09
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34010682A1041C0700X
MD320711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical