Active NPI
Timothy Hernandez, LADC I
- Addiction (Substance Use Disorder) Counselor
- Fairhaven, MA
National Provider Identifier
1336501691
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 11680
- Practice address
- 295 Sconticut Neck Rd
Fairhaven, MA 02719-1506 - Phone
- (508) 863-6733
- NPI assigned
- Mar 25, 2016
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 11680 | MA | Primary |
Addresses
Primary practice location
295 Sconticut Neck Rd
Fairhaven, MA 02719-1506
Mailing address
295 Sconticut Neck Rd
Fairhaven, MA 02719-1506
Phone (508) 863-6733
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
| License | State | Type | Specialty |
|---|---|---|---|
| 11680 | MA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1458864000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1458864000000",
"number": "1336501691",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "295 SCONTICUT NECK RD",
"city": "FAIRHAVEN",
"state": "MA",
"postal_code": "027191506",
"telephone_number": "508-863-6733"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "295 SCONTICUT NECK RD",
"city": "FAIRHAVEN",
"state": "MA",
"postal_code": "027191506",
"telephone_number": "508-863-6733"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERNANDEZ",
"first_name": "TIMOTHY",
"credential": "LADC I",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-03-25",
"last_updated": "2016-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MA",
"license": "11680",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairhaven, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.