NPIMap

Individual provider Active NPI

Daniel E Hermsen, LCSW

  • Clinical Social Worker
  • Waukesha, WI
National Provider Identifier
1013078518
Registry record updated Aug 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3457 Issued in WI
Practice address
W231 N1440 Corporate Court
Suite 310
Waukesha, WI 53186-1301
Phone
(282) 896-6186
Fax
(262) 896-6139
NPI assigned
Dec 12, 2006
Last updated
Aug 9, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 11162 WI
Clinical Social Worker 1041C0700X 3457-123 WI
Clinical Social Worker 1041C0700X 3457 WI Primary

Addresses

Primary practice location

W231 N1440 Corporate Court
Suite 310
Waukesha, WI 53186-1301

Mailing address

W231 N1440 Corporate Court
Suite 310
Waukesha, WI 53186-1303
Phone (262) 896-6186

Other identifiers 1

IdentifierTypeStateIssuer
39385700MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
3457WIMDClinical Social Worker
3457-123WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Systemic Perspectives, Inc. Past Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344470400000",
    "number": "1013078518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W231 N1440 CORPORATE COURT",
            "address_2": "SUITE 310",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531861303",
            "telephone_number": "262-896-6186",
            "fax_number": "262-896-6139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W231 N1440 CORPORATE COURT",
            "address_2": "SUITE 310",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531861301",
            "telephone_number": "282-896-6186",
            "fax_number": "262-896-6139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERMSEN",
        "first_name": "DANIEL",
        "middle_name": "E",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2012-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "11162",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "3457-123",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "3457",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39385700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.