Active NPI
Karen Hernandez, LICSW
- Clinical Social Worker
- Mankato, MN
National Provider Identifier
1053184705
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 30306
- Practice address
- 226 N Broad St Ste 101
Mankato, MN 56001-3520 - Phone
- (507) 931-8040
- Fax
- (507) 931-8060
- NPI assigned
- Nov 3, 2023
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 30306 | MN | Primary |
Addresses
Primary practice location
226 N Broad St Ste 101
Mankato, MN 56001-3520
Mailing address
226 N Broad St Ste 101
Mankato, MN 56001-3520
Phone (612) 315-0713
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- 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 |
|---|---|---|---|---|
| I20240123004310 | MN | Practitioner - Clinical Social Worker | 8527410778 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30306 | MN | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Therapy Is Cool LLC | Clinical | Current | Accepting new patients |
Locations
1400 Madison Ave
Ste 602
Mankato, MN 56001
Phone (507) 345-7836
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": "1698969600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698969600000",
"number": "1053184705",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "226 N BROAD ST STE 101",
"city": "MANKATO",
"state": "MN",
"postal_code": "560013520",
"telephone_number": "612-315-0713",
"fax_number": "507-931-8060"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "226 N BROAD ST STE 101",
"city": "MANKATO",
"state": "MN",
"postal_code": "560013520",
"telephone_number": "507-931-8040",
"fax_number": "507-931-8060"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERNANDEZ",
"first_name": "KAREN",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-11-03",
"last_updated": "2023-11-03",
"certification_date": "2023-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MN",
"license": "30306",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Mankato, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2023; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.