Individual provider Active NPI

Denise Marie Herheim

  • Clinical Social Worker
  • Gouverneur, NY
National Provider Identifier
1083264857
Registry record updated Sep 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
101210 Issued in NY
Practice address
28 William St
Gouverneur, NY 13642-1405
Phone
(315) 287-2811
NPI assigned
Sep 13, 2019
Last updated
Sep 13, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2019

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 101210 NY Primary

Addresses

Primary practice location

28 William St
Gouverneur, NY 13642-1405

Mailing address

28 William St
Gouverneur, NY 13642-1405
Phone (315) 287-2811

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
101210NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
St. Lawrence Psychiatric Center PastSince Sep 15, 2019 Accepting new patients
St. Lawrence Psychiatric Center PastSince Sep 15, 2019 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1568332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568332800000",
    "number": "1083264857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 WILLIAM ST",
            "city": "GOUVERNEUR",
            "state": "NY",
            "postal_code": "136421405",
            "telephone_number": "315-287-2811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 WILLIAM ST",
            "city": "GOUVERNEUR",
            "state": "NY",
            "postal_code": "136421405",
            "telephone_number": "315-287-2811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERHEIM",
        "first_name": "DENISE",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-13",
        "last_updated": "2019-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "101210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gouverneur, NY

Sources for this page

Verify at the official NPI Registry.