REBECCA SUE HARTSELL, RN, MSN, LCAS — NPI 1508969643 (Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Clinical Nurse Specialist, Psychiatric — Mental Health, Child & Adolescent in CONCORD, NC)

CMS-1500 Box 24J / 33a • NPI

1508969643

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

364SP0807X (CMS 89)

Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Clinical Nurse Specialist, Psychiatric — Mental Health, Child & Adolescent

Box 32 Service Location & ZIP+4

930 LEE ANN DR NE, CONCORD, NC, 28025-2957

✓ 9-Digit EDI 837 ZIP+4 (28025-2957)

Practice Phone & Referral Fax

(704) 786-9205

Fax: (704) 721-6056

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1508969643 (REBECCA SUE HARTSELL, RN, MSN, LCAS) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1508969643` (NPI-1 Individual Practitioner)
Provider / Legal Name	REBECCA SUE HARTSELL, RN, MSN, LCAS
Plain-English Specialty	Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Clinical Nurse Specialist, Psychiatric — Mental Health, Child & Adolescent NUCC Code: `364SP0807X` (Clinical Nurse Specialist, Psych/Mental Health, Child & Adolescent)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	930 LEE ANN DR NE, CONCORD, NC, 28025-2957
Practice Telephone / Fax	Tel: (704) 786-9205 \| Fax: (704) 721-6056
Administrative Mailing Address	1117 ALLMAN ROAD EXT, MT PLEASANT, NC, 28124-9588
Enumeration & Last Sync	Enumerated: 2006-09-06 \| CMS Record Updated: 2025-09-11

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

930 LEE ANN DR NE, CONCORD, NC, 28025-2957

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Plain-English Taxonomy & CMS Crosswalk (364SP0807X)

What Does Taxonomy Code 364SP0807X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 364SP0807X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Clinical Nurse Specialist, Psychiatric — Mental Health, Child & Adolescent"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 89 (Certified Clinical Nurse Specialist)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Clinical Nurse Specialist, Psych/Mental Health, Child & Adolescent for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (REBECCA SUE HARTSELL, RN, MSN, LCAS)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`101YA0400X` — Counselor, Addiction (Substance Use Disorder) Plain English: Licensed & Credentialed Counselor, Addiction (Substance Use Disorder)	State: NC \| License: `LCAS 841` \| Primary: Secondary
`364SP0807X` — Clinical Nurse Specialist, Psych/Mental Health, Child & Adolescent Plain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Clinical Nurse Specialist, Psychiatric — Mental Health, Child & Adolescent	State: NC \| License: `RN 045785` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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REBECCA SUE HARTSELL, RN, MSN, LCAS (NPI #1508969643)