Individual provider Active NPI

Paula Marie Hernandez, MSW

  • Clinical Social Worker
  • Redford, MI
National Provider Identifier
1063949279
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801097188 Issued in MI
Practice address
9315 Telegraph Rd
Redford, MI 48239-1260
Phone
(313) 450-4500
Fax
(313) 450-0004
NPI assigned
May 18, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801097188 MI Primary
Clinical Social Worker 1041C0700X 6852093509 MI

Addresses

Primary practice location

9315 Telegraph Rd
Redford, MI 48239-1260

Mailing address

15591 Warwick Ave
Allen Park, MI 48101-2727
Phone (313) 550-8118

Other practice location 1

1600 Porter St
Detroit, MI 48216-1936
Phone (313) 963-6601 ext. 4111

Other practice location 2

19275 Northline Rd Bldg 7
Southgate, MI 48195-2220
Phone (734) 785-7716

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
6852093509MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lincoln Behavioral Services Past Accepting new patients
Lincoln Behavioral Services Past Accepting new patients

Organizations & group practices 2

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": "1495065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1063949279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15591 WARWICK AVE",
            "city": "ALLEN PARK",
            "state": "MI",
            "postal_code": "481012727",
            "telephone_number": "313-550-8118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9315 TELEGRAPH RD",
            "city": "REDFORD",
            "state": "MI",
            "postal_code": "482391260",
            "telephone_number": "313-450-4500",
            "fax_number": "313-450-0004"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 Porter St",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482161936",
            "country_code": "US",
            "telephone_number": "313-963-6601 x4111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "19275 Northline Rd Bldg 7",
            "address_purpose": "LOCATION",
            "city": "Southgate",
            "state": "MI",
            "postal_code": "481952220",
            "country_code": "US",
            "telephone_number": "734-785-7716",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "PAULA",
        "middle_name": "MARIE",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-18",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801097188",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6852093509",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redford, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2024; 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.