Active NPI
Nicole Christine Hernandez, PHD
- Clinical Psychologist
- Macomb, IL
National Provider Identifier
1205221439
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 071.008971
- Practice address
- 210 S Randolph St
Macomb, IL 61455-3828 - Phone
- (734) 673-1672
- NPI assigned
- Apr 3, 2015
- 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 Psychologist | 103TC0700X | 071.008971 | IL | Primary |
Addresses
Primary practice location
210 S Randolph St
Macomb, IL 61455-3828
Mailing address
615 W Hamilton St
Rushville, IL 62681-1371
Phone (734) 673-1672
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)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1428019200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1428019200000",
"number": "1205221439",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "615 W HAMILTON ST",
"city": "RUSHVILLE",
"state": "IL",
"postal_code": "626811371",
"telephone_number": "734-673-1672"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "210 S RANDOLPH ST",
"city": "MACOMB",
"state": "IL",
"postal_code": "614553828",
"telephone_number": "734-673-1672"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERNANDEZ",
"first_name": "NICOLE",
"middle_name": "CHRISTINE",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-04-03",
"last_updated": "2015-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IL",
"license": "071.008971",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Macomb, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 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.