Stephen William Henneka, L.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW0002939 Issued in FL

Practice address

1100 S Ponce de Leon Blvd Ste 1
Saint Augustine, FL 32084-6013

Phone

(904) 824-7733

Fax

(904) 829-9768

NPI assigned

Oct 15, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1160870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421193600000",
    "number": "1104916428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 S PONCE DE LEON BLVD STE 1",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320846013",
            "telephone_number": "904-824-7733",
            "fax_number": "904-829-9768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 S PONCE DE LEON BLVD STE 1",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320846013",
            "telephone_number": "904-824-7733",
            "fax_number": "904-829-9768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNEKA",
        "first_name": "STEPHEN",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-15",
        "last_updated": "2015-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "SW0002939",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW0002939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chnese Henderson, ASW
• Lauren Colby Hendricks, ARNP
• Audrey Hendrix
• Kelly Henke
• Dustin Stephen Henneka, MSW
• Christopher Hans Henry, DMD MS PC
• Holly Jo Henry, R.D.
• Jane Ellen Henry, APRN
• Joshua Michael Henry, MD
• Diana Hensley

• Clinical Social Worker in Saint Augustine, FL
• Providers in Saint Augustine, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2015; 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.