Individual provider Active NPI

Kerry Joyce Heckman, LCSW

  • Clinical Social Worker
  • Seattle, WA
National Provider Identifier
1013407980
Registry record updated May 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149018199 Issued in IL
Practice address
430 8TH Ave N Apt 722
Seattle, WA 98109-4795
Phone
(312) 371-5632
NPI assigned
May 15, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149018199 IL Primary

Addresses

Primary practice location

430 8TH Ave N Apt 722
Seattle, WA 98109-4795

Mailing address

430 8TH Ave N Apt 722
Seattle, WA 98109-4795
Phone (312) 371-5632

Other names 1

  • Kerry Joyce Hammergren Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
149018199ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1526342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526342400000",
    "number": "1013407980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 8TH AVE N APT 722",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981094795",
            "telephone_number": "312-371-5632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 8TH AVE N APT 722",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981094795",
            "telephone_number": "312-371-5632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HECKMAN",
        "first_name": "KERRY",
        "middle_name": "JOYCE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-15",
        "last_updated": "2018-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149018199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KERRY",
            "last_name": "HAMMERGREN",
            "middle_name": "JOYCE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2018; 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.