Individual provider Active NPI

Mary E. Herschberger, LICSW-A

  • Clinical Social Worker
  • Spokane, WA
National Provider Identifier
1205658820
Registry record updated Oct 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
61604309 Issued in WA
Practice address
1111 E Westview CT Ste B
Spokane, WA 99218-1376
Phone
(509) 626-9430
Fax
(509) 626-9436
NPI assigned
Oct 25, 2024
Last updated
Oct 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 61604309 WA Primary

Addresses

Primary practice location

1111 E Westview CT Ste B
Spokane, WA 99218-1376

Mailing address

1111 E Westview CT Ste B
Spokane, WA 99218-1376
Phone (509) 626-9430

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
61604309WAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1729814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729814400000",
    "number": "1205658820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 E WESTVIEW CT STE B",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992181376",
            "telephone_number": "509-626-9430",
            "fax_number": "509-626-9436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 E WESTVIEW CT STE B",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992181376",
            "telephone_number": "509-626-9430",
            "fax_number": "509-626-9436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERSCHBERGER",
        "first_name": "MARY",
        "middle_name": "E.",
        "credential": "LICSW-A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-25",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "61604309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2024; 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.