NPIMap

Individual provider Active NPI

William J Fernholz, LSCSW

  • Clinical Social Worker
  • Overland Park, KS
National Provider Identifier
1013350503
Registry record updated Jul 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
4418 Issued in KS
Practice address
10977 Granada LN
Suite 250
Overland Park, KS 66211-1468
Phone
(913) 416-4796
NPI assigned
Apr 15, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 8148 KS
Clinical Social Worker 1041C0700X 4418 KS Primary

Addresses

Primary practice location

10977 Granada LN
Suite 250
Overland Park, KS 66211-1468

Mailing address

7707 W 90TH Ter
Overland Park, KS 66212-2107
Phone (913) 416-4796

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
8148KSMDSocial Worker
4418KSMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Connections Counseling, LLC Social Worker Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1365984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436400000000",
    "number": "1013350503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7707 W 90TH TER",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662122107",
            "telephone_number": "913-416-4796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10977 GRANADA LN",
            "address_2": "SUITE 250",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662111468",
            "telephone_number": "913-416-4796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNHOLZ",
        "first_name": "WILLIAM",
        "middle_name": "J",
        "credential": "LSCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-15",
        "last_updated": "2015-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "KS",
            "license": "8148",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "4418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2015; 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.