Active NPI
Jesse L Herman Jr., LMSW
- Social Worker
- Renton, WA
National Provider Identifier
1023616794
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 14217
- Practice address
- 419 S 2ND St Ste 2
Renton, WA 98057-2234 - Phone
- (425) 203-7200
- Fax
- (425) 203-7217
- NPI assigned
- Oct 14, 2020
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 14217 | SC | Primary |
Addresses
Primary practice location
419 S 2ND St Ste 2
Renton, WA 98057-2234
Mailing address
11605 Tetrafin Dr
Riverview, FL 33579-4088
Phone (314) 484-8430
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
| License | State | Type | Specialty |
|---|---|---|---|
| 14217 | SC | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1602633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621382400000",
"number": "1023616794",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11605 TETRAFIN DR",
"city": "RIVERVIEW",
"state": "FL",
"postal_code": "335794088",
"telephone_number": "314-484-8430"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "419 S 2ND ST STE 2",
"city": "RENTON",
"state": "WA",
"postal_code": "980572234",
"telephone_number": "425-203-7200",
"fax_number": "425-203-7217"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERMAN",
"first_name": "JESSE",
"middle_name": "L",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-10-14",
"last_updated": "2021-05-19",
"certification_date": "2021-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "SC",
"license": "14217",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Renton, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.