Hackett, Revae L

Hackett, Revae L is an individual health care provider with primary practice located at 11577 Finnegans Way , Oregon City OR 97045-9770. She recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Hackett, Revae L can be contacted via phone (971) 252-5517.

Contact Information

Primary practice address
11577 Finnegans Way Oregon City OR 97045-9770
Phone: (971) 252-5517
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X R4238 Oregon
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X
Behavioral Health & Social Service Providers / Professional 101YP2500X C4820 Oregon
Behavioral Health & Social Service Providers / Mental Health 101YM0800X Oregon

Profile Details

NPI number 1558766923
LBN Legal business name Hackett, Revae L
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 28th, 2014
Last updated Jun 21st, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558766923 NPPES
Oregon MEDICAID 500678512

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