Carol Herndon, L.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34003517A Issued in IN

Practice address

1910 Saint Joe Center Rd
Ste 23
Fort Wayne, IN 46825-5000

Phone

(260) 484-5599

NPI assigned

Apr 5, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Dunn Associates PCGroup PAC ID 0648376210, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Dunn Associates PC

  • Mental Health Counselor
  • Fort Wayne, IN
  • NPI 1740362391
  Medicare reassignment Care Compare group
• Elevation Enterprises, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fort Wayne, IN
  • NPI 1538932728
  NPD

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

{
    "created_epoch": "1301961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642377600000",
    "number": "1245529734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 SAINT JOE CENTER RD",
            "address_2": "STE 23",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468255000",
            "telephone_number": "260-494-6529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 SAINT JOE CENTER RD",
            "address_2": "STE 23",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468255000",
            "telephone_number": "260-484-5599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNDON",
        "first_name": "CAROL",
        "name_prefix": "Mrs.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-05",
        "last_updated": "2022-01-17",
        "certification_date": "2022-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34003517A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tina J Hermes, NP
• Caitlin Emily Hernandez, D.C.
• Jacqueline J. Hernandez, NP
• Vivian O. Hernandez, PH.D., HSPP
• Bruce Herndon
• Kerry Herndon
• Brian D Herr, M.D.
• Beth Ann Herrell, MS, ATC, LAT, CSCS
• Andy Alvarez Herrera, MD
• Jamie Lynn Herring, MA, LMFT

• Clinical Social Worker in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.