Individual provider Active NPI

Teresa E Hernandez, LSCSW

  • Clinical Social Worker
  • Salina, KS
National Provider Identifier
1083665731
Registry record updated Oct 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LSCSW 4164 Issued in KS
Practice address
215 S Santa Fe Ave
Suite 102
Salina, KS 67401-3980
Phone
(785) 404-6065
NPI assigned
May 15, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2012

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 LSCSW 4164 KS Primary

Addresses

Primary practice location

215 S Santa Fe Ave
Suite 102
Salina, KS 67401-3980

Mailing address

322 S 11TH St
Salina, KS 67401-3819
Phone (785) 787-2300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20130102000071 KS Practitioner - Clinical Social Worker 6204089162 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

336 S Santa Fe Ave
Suite 5
Salina, KS 67401-3934
Phone (785) 404-6065

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LSCSW 4164KSMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Hernandez Enterprises, LLC Clinical CurrentSince Mar 20, 2020 Accepting new patients
Center for Counseling and Consultation CurrentSince Aug 27, 2020 Accepting new patients

Locations

5815 Broadway Ave
Great Bend, KS 67530
Phone (620) 792-2544

215 S Santa Fe Ave
Ste 102
Salina, KS 67401
Phone (785) 404-6065

336 S Santa Fe Ave
Ste 5
Salina, KS 67401
Phone (785) 404-6065

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": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351036800000",
    "number": "1083665731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 S 11TH ST",
            "city": "SALINA",
            "state": "KS",
            "postal_code": "674013819",
            "telephone_number": "785-787-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 S SANTA FE AVE",
            "address_2": "SUITE 102",
            "city": "SALINA",
            "state": "KS",
            "postal_code": "674013980",
            "telephone_number": "785-404-6065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "TERESA",
        "middle_name": "E",
        "credential": "LSCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-15",
        "last_updated": "2012-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "LSCSW 4164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salina, KS

Sources for this page

Verify at the official NPI Registry.