Individual provider Active NPI

Sheyenne Dawn Hernandez

  • Clinical Social Worker
  • Idaho Falls, ID
National Provider Identifier
1194617845
Registry record updated Jul 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LMSW45186 Issued in ID
Practice address
1248 E 17TH St
Idaho Falls, ID 83404-6126
Phone
(208) 542-1026
NPI assigned
Jul 17, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
School Social Worker 1041S0200X LSW-31953 ID
Clinical Social Worker 1041C0700X LMSW45186 ID Primary

Addresses

Primary practice location

1248 E 17TH St
Idaho Falls, ID 83404-6126

Mailing address

69 N 900 W
Blackfoot, ID 83221-5390
Phone (208) 681-3013

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

LicenseStateTypeSpecialty
LMSW45186IDMDClinical Social Worker
LSW-31953IDMDSchool Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1752710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752710400000",
    "number": "1194617845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69 N 900 W",
            "city": "BLACKFOOT",
            "state": "ID",
            "postal_code": "832215390",
            "telephone_number": "208-681-3013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1248 E 17TH ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046126",
            "telephone_number": "208-542-1026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "SHEYENNE",
        "middle_name": "DAWN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-17",
        "last_updated": "2025-07-17",
        "certification_date": "2025-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "ID",
            "license": "LSW-31953",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LMSW45186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2025; 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.