Individual provider Active NPI

Thomas Hernandez, LMSW

  • Clinical Social Worker
  • Joplin, MO
National Provider Identifier
1396266573
Registry record updated Jul 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2022023198 Issued in MO
Practice address
3901 E 32ND St
Joplin, MO 64804-3312
Phone
(417) 347-7567
NPI assigned
Jun 28, 2017
Last updated
Jul 11, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 8509-M AR
Social Worker 104100000X
Clinical Social Worker 1041C0700X 2022023198 MO Primary

Addresses

Primary practice location

3901 E 32ND St
Joplin, MO 64804-3312

Mailing address

PO Box 2526
Joplin, MO 64803-2526
Phone (417) 347-7567

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20220801000989 MO Practitioner - Clinical Social Worker 9234511759 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Counseling Associates of the Four States LLCGroup PAC ID 7012160435, 10 clinicians

Practice addresses (Care Compare)

705 W 26TH St
Joplin, MO 64804-1904
Phone (417) 627-9994

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8509-MARMDSocial Worker
2022023198MOMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling Associates of the Four States, LLC CurrentSince Jul 1, 2025 Accepting new patients

Locations

705 W 26th St
Joplin, MO 64804
Phone (417) 627-9994

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1498608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657497600000",
    "number": "1396266573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2526",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648032526",
            "telephone_number": "417-347-7567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 E 32ND ST",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648043312",
            "telephone_number": "417-347-7567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "THOMAS",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-28",
        "last_updated": "2022-07-11",
        "certification_date": "2022-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AR",
            "license": "8509-M",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2022023198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joplin, MO

Sources for this page

Verify at the official NPI Registry.