Active NPI
Ellen Hernandez, LCSW
- Clinical Social Worker
- Hartford, CT
National Provider Identifier
1124101480
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 005014
- Practice address
- 56 Arbor St Ste 215
Hartford, CT 06106-1201 - Phone
- (860) 233-1345
- Fax
- (860) 233-1346
- NPI assigned
- Oct 23, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 005014 | CT | Primary |
Addresses
Primary practice location
56 Arbor St Ste 215
Hartford, CT 06106-1201
Mailing address
11 Barton Hill Rd
East Hampton, CT 06424-1130
Phone (860) 478-2229
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 140005014CT02 | Other | CT | ANTHEM BEHAVIORAL HEALTH |
| P3513598 | Other | CT | OXFORD |
| 11242719 | Other | CT | CAQH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 22, 2024 through Jan 22, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1124101480",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 BARTON HILL RD",
"city": "EAST HAMPTON",
"state": "CT",
"postal_code": "064241130",
"telephone_number": "860-478-2229"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "56 ARBOR ST STE 215",
"city": "HARTFORD",
"state": "CT",
"postal_code": "061061201",
"telephone_number": "860-233-1345",
"fax_number": "860-233-1346"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERNANDEZ",
"first_name": "ELLEN",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CT",
"license": "005014",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BEHAVIORAL HEALTH",
"identifier": "140005014CT02",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD",
"identifier": "P3513598",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "11242719",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hartford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.