Active NPI
Edward Charles Herman, LICSW
- Clinical Social Worker
- Shelton, WA
National Provider Identifier
1003278755
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LW00009674
- Practice address
- 50 SE Bluff Loop Rd.
Shelton, WA 98584 - Phone
- (360) 580-1054
- NPI assigned
- Mar 22, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LW00009674 | WA | Primary |
Addresses
Primary practice location
50 SE Bluff Loop Rd.
Shelton, WA 98584
Mailing address
50 SE Bluff Loop Rd.
Shelton, WA 98584
Phone (360) 580-1054
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161020001326 | WA | Practitioner - Clinical Social Worker | 2567740889 | Practice locations: Olympia, WA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
1820 Black Lake Blvd SW
Suite 101
Olympia, WA 98512-5619
Phone (360) 545-3259
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1458604800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1458604800000",
"number": "1003278755",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "50 SE BLUFF LOOP RD.",
"city": "SHELTON",
"state": "WA",
"postal_code": "98584",
"telephone_number": "360-580-1054"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "50 SE BLUFF LOOP RD.",
"city": "SHELTON",
"state": "WA",
"postal_code": "98584",
"telephone_number": "360-580-1054"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERMAN",
"first_name": "EDWARD",
"middle_name": "CHARLES",
"credential": "LICSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-03-22",
"last_updated": "2016-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WA",
"license": "LW00009674",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shelton, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.