Active NPI
Martin Hernandez, LCSW
- Clinical Social Worker
- Hampstead, NC
National Provider Identifier
1356719413
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- C006570
- Practice address
- 304 Shearwater Dr
Hampstead, NC 28443-2479 - Phone
- (910) 262-1144
- NPI assigned
- Sep 7, 2015
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | C006570 | NC | Primary |
Addresses
Primary practice location
304 Shearwater Dr
Hampstead, NC 28443-2479
Mailing address
304 Shearwater Dr
Hampstead, NC 28443-2479
Phone (910) 599-7062
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Oct 23, 2023 through Oct 23, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C006570 | NC | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1441584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1700092800000",
"number": "1356719413",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "304 SHEARWATER DR",
"city": "HAMPSTEAD",
"state": "NC",
"postal_code": "284432479",
"telephone_number": "910-599-7062"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "304 SHEARWATER DR",
"city": "HAMPSTEAD",
"state": "NC",
"postal_code": "284432479",
"telephone_number": "910-262-1144"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERNANDEZ",
"first_name": "MARTIN",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-09-07",
"last_updated": "2023-11-16",
"certification_date": "2023-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "C006570",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hampstead, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.