Individual provider Active NPI

Hershel Korngut

  • Addiction (Substance Use Disorder) Counselor
  • Sherman Oaks, CA
National Provider Identifier
1396280087
Registry record updated May 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
R1539061223 Issued in CA
Practice address
4859 Coldwater Canyon Ave Apt 15
Sherman Oaks, CA 91423-2235
Phone
(626) 528-2587
NPI assigned
Jan 4, 2017
Reactivated
May 27, 2022
Last updated
May 30, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X R1539061223 CA Primary

Addresses

Primary practice location

4859 Coldwater Canyon Ave Apt 15
Sherman Oaks, CA 91423-2235

Mailing address

4859 Coldwater Canyon Ave Apt 15
Sherman Oaks, CA 91423-2235
Phone (626) 528-2587

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

LicenseStateTypeSpecialty
R1539061223CAMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1483488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717027200000",
    "number": "1396280087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4859 COLDWATER CANYON AVE APT 15",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914232235",
            "telephone_number": "626-528-2587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4859 COLDWATER CANYON AVE APT 15",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914232235",
            "telephone_number": "626-528-2587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORNGUT",
        "first_name": "HERSHEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-04",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "deactivation_date": "2022-04-28",
        "reactivation_date": "2022-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "R1539061223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.