Healthcare Provider Details

I. General information

NPI: 1174116677
Provider Name (Legal Business Name): REBECCA JENE HASSELL LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: REBECCA JENE PLEIN LLMSW

II. Dates (important events)

Enumeration Date: 02/16/2021
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13305 REECK CT
SOUTHGATE MI
48195-3197
US

IV. Provider business mailing address

6549 TOWN CENTER DR STE A
CLARKSTON MI
48346-4824
US

V. Phone/Fax

Practice location:
  • Phone: 800-395-3223
  • Fax:
Mailing address:
  • Phone: 800-395-3223
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6851117228
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801121218
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: