Individual provider Active NPI

Gabriel Hernandez, LMSW

  • Social Worker
  • Holland, MI
National Provider Identifier
1114545423
Registry record updated Sep 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801118969 Issued in MI
Practice address
483 Century LN
Holland, MI 49423-4286
Phone
(616) 610-3874
NPI assigned
Jul 13, 2020
Last updated
Sep 19, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801118969 MI Primary
Social Worker 104100000X 6802090922 MI
Case Manager/Care Coordinator 171M00000X NU

Addresses

Primary practice location

483 Century LN
Holland, MI 49423-4286

Mailing address

483 Century LN
Holland, MI 49423-4286

Other practice location 1

170 College Ave Ste 310
Holland, MI 49423-2982
Phone (616) 426-9034 ext. 603

Other practice location 2

719 N Center Dr NW
Walker, MI 49544-8215
Phone (616) 791-1610

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
I20241104002966 MI Practitioner - Clinical Social Worker 8921531575 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

540 Jenner Dr
Allegan, MI 49010-1517
Phone (269) 673-6617

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801118969MIMDSocial Worker
6802090922MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Second Story Counseling II LLC CurrentSince Mar 4, 2025 Accepting new patients
Reach for Recovery, Inc. Case Manager/Care Coordinator CurrentSince Oct 1, 2024 Accepting new patients
Arbor Circle Corporation CurrentSince Oct 6, 2025 Accepting new patients
Allegan County Community Mental Health Services CurrentSince Aug 3, 2025 Accepting new patients
Allegan County Community Mental Health Services CurrentSince Aug 3, 2025 Accepting new patients
Reach for Recovery, Inc. Case Manager/Care Coordinator CurrentSince Oct 1, 2024 Accepting new patients

Locations

3285 122nd Ave
Allegan, MI 49010
Phone (269) 673-6617

540 Jenner Dr
Allegan, MI 49010
Phone (269) 673-6617

1101 Ball Ave NE
Grand Rapids, MI 49505
Phone (616) 456-7775

1115 Ball Ave NE
Grand Rapids, MI 49505
Phone (616) 451-3001

170 College Ave
Ste 310
Holland, MI 49423
Phone (616) 426-9034

483 Century Ln
Holland, MI 49423
Phone (616) 396-5284

Organizations & group practices 7

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": "1594598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1114545423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "483 CENTURY LN",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494234286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "483 CENTURY LN",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494234286",
            "telephone_number": "616-610-3874"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "170 College Ave Ste 310",
            "address_purpose": "LOCATION",
            "city": "Holland",
            "state": "MI",
            "postal_code": "494232982",
            "country_code": "US",
            "telephone_number": "616-426-9034 x603",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "719 N Center Dr NW",
            "address_purpose": "LOCATION",
            "city": "Walker",
            "state": "MI",
            "postal_code": "495448215",
            "country_code": "US",
            "telephone_number": "616-791-1610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "GABRIEL",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-13",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801118969",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6802090922",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holland, MI

Sources for this page

Verify at the official NPI Registry.