Bridgette Herrin Mavec, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2003020965 Issued in MO

Practice address

7830 Caenen St
Lenexa, KS 66216-3326

Phone

(913) 208-3985

NPI assigned

Oct 19, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MO

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

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Sondermind Provider Network LLC

  • Clinical Social Worker
  • Denver, CO
  • NPI 1760854442

  MO

  Medicare reassignment NPD
• Resilience Psychotherapy LCSW PC

  • Clinical Social Worker
  • New York, NY
  • NPI 1003459694
  NPD (past)

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

{
    "created_epoch": "1603065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603065600000",
    "number": "1265031579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7830 CAENEN ST",
            "city": "LENEXA",
            "state": "KS",
            "postal_code": "662163326",
            "telephone_number": "913-208-3985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7830 CAENEN ST",
            "city": "LENEXA",
            "state": "KS",
            "postal_code": "662163326",
            "telephone_number": "913-208-3985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRIN MAVEC",
        "first_name": "BRIDGETTE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-19",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2003020965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "lenexa",
            "affiliation": "N",
            "endpointDescription": "Home office",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct",
            "address_1": "7830 Caenen St",
            "city": "Lenexa",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662163326",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lysha Henneberg
• Claire Elizabeth Henson
• Pablo J Hernandez-Rios, MD
• Clara Hernandez, RPH
• Devan Myrinda Heronemus, PT, DPT
• Shawn Allen Herrman, DC
• Andrew Vaughan Herwig, DDS
• Caryn Hess, LPC
• Rebekah Angel Hess
• Christopher William Heye, DDS

• Clinical Social Worker in Lenexa, KS
• Providers in Lenexa, KS by specialty
• Clinical Social Worker in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.