Active NPI
Haydee Hernandez Carrillo, LMSW
- Social Worker
- Laredo, TX
National Provider Identifier
1194480079
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 105302
- Practice address
- 8709 Martinique Dr
Laredo, TX 78045-8007 - Phone
- (956) 645-7728
- NPI assigned
- Nov 4, 2021
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 105302 | TX | Primary |
Addresses
Primary practice location
8709 Martinique Dr
Laredo, TX 78045-8007
Mailing address
8709 Martinique Dr
Laredo, TX 78045-8007
Phone (956) 645-7728
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 105302 | TX | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1635984000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635984000000",
"number": "1194480079",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8709 MARTINIQUE DR",
"city": "LAREDO",
"state": "TX",
"postal_code": "780458007",
"telephone_number": "956-645-7728"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8709 MARTINIQUE DR",
"city": "LAREDO",
"state": "TX",
"postal_code": "780458007",
"telephone_number": "956-645-7728"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARRILLO",
"first_name": "HAYDEE",
"middle_name": "HERNANDEZ",
"credential": "LMSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-11-04",
"last_updated": "2021-11-04",
"certification_date": "2021-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Social Worker",
"state": "TX",
"license": "105302",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Laredo, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.