Healthcare Provider Details

I. General information

NPI: 1023899937
Provider Name (Legal Business Name): REBEKAH SUZANNE HESSE MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2023
Last Update Date: 06/24/2025
Certification Date: 06/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5241 GREEN BRIDGE RD
DAYTON MD
21036-1203
US

IV. Provider business mailing address

5241 GREEN BRIDGE RD
DAYTON MD
21036-1203
US

V. Phone/Fax

Practice location:
  • Phone: 219-973-7878
  • Fax:
Mailing address:
  • Phone: 219-973-7878
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904017329
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number34010682A
License Number StateIN
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number32071
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: