Individual provider Active NPI

Tiefa Nichole Hernandez, LCSW

  • Clinical Social Worker
  • Lafayette, IN
National Provider Identifier
1275424293
Registry record updated Sep 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34012113A Issued in IN
Practice address
3720 Tularosa Dr
Lafayette, IN 47905-4058
Phone
(765) 202-4019
Fax
(765) 202-4019
NPI assigned
Jul 9, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2025

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 34012113A IN Primary

Addresses

Primary practice location

3720 Tularosa Dr
Lafayette, IN 47905-4058

Mailing address

3720 Tularosa Dr
Lafayette, IN 47905-4058
Phone (765) 202-4019

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250912000637 IN Practitioner - Clinical Social Worker 4183127400 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4315 Commerce Dr
Suite 440
Lafayette, IN 47905-3825
Phone (765) 233-2001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rise and Shine Therapy LLC Clinical CurrentSince Jul 13, 2025 Accepting new patients
Brave Health Medical Group PA CurrentSince Jul 22, 2025 Accepting new patients

Locations

1951 NW 7th Ave
Fl 3
Miami, FL 33136
Phone (305) 297-4749

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1752019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757030400000",
    "number": "1275424293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3720 TULAROSA DR",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479054058",
            "telephone_number": "765-202-4019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3720 TULAROSA DR",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479054058",
            "telephone_number": "765-202-4019",
            "fax_number": "765-202-4019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "TIEFA",
        "middle_name": "NICHOLE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-09",
        "last_updated": "2025-09-05",
        "certification_date": "2025-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34012113A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, IN

Sources for this page

Verify at the official NPI Registry.