Individual provider Active NPI

Michael Hernandez

  • Clinical Social Worker
  • Saginaw, MI
National Provider Identifier
1053741199
Registry record updated Jun 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801110264 Issued in MI
Practice address
203 S Washington Ave Ste 310
Saginaw, MI 48607-1215
Phone
(989) 793-4790
NPI assigned
Nov 26, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6802087531 MI
Other Technician 247200000X
Clinical Social Worker 1041C0700X 6801110264 MI Primary

Addresses

Primary practice location

203 S Washington Ave Ste 310
Saginaw, MI 48607-1215

Mailing address

203 S Washington Ave Ste 310
Saginaw, MI 48607-1215
Phone (989) 793-4790

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250430000752 MI Practitioner - Clinical Social Worker 3577089895 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Community Mental Health for Central MichiganGroup PAC ID 4688660533, 44 clinicians

Practice addresses (Care Compare)

218 Fast Ice Dr
Midland, MI 48642-6167
Phone (989) 631-2320

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801110264MIMDClinical Social Worker
6802087531MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Community Mental Health for Central Michigan Clinical CurrentSince Mar 10, 2025 Accepting new patients
Westlund Guidance Clinic Clinical CurrentSince Feb 13, 2022 Accepting new patients
Westlund Guidance Clinic PastSince Jun 27, 2021 Accepting new patients
Community Mental Health for Central Michigan Clinical PastSince Nov 24, 2019 Accepting new patients

Locations

218 Fast Ice Dr
Midland, MI 48642
Phone (989) 631-2320

301 S Crapo St
Ste 200
Mt Pleasant, MI 48858
Phone (989) 772-5938

301 S Crapo St
Ste 100
Mt Pleasant, MI 48858
Phone (989) 772-5938

203 S Washington Ave
Ste 310
Saginaw, MI 48607
Phone (989) 245-3092

Organizations & group practices 4

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": "1385424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624579200000",
    "number": "1053741199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 S WASHINGTON AVE STE 310",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486071215",
            "telephone_number": "989-793-4790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 S WASHINGTON AVE STE 310",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486071215",
            "telephone_number": "989-793-4790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-11-26",
        "last_updated": "2021-06-25",
        "certification_date": "2021-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6802087531",
            "primary": false
        },
        {
            "code": "247200000X",
            "taxonomy_group": "",
            "desc": "Technician, Other",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801110264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saginaw, MI

Sources for this page

Verify at the official NPI Registry.