Active NPI
David A Hernandez, LCSW
- Clinical Social Worker
- Lakeland, FL
National Provider Identifier
1447504733
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 10505
- Practice address
- 215 E Bay St
2
Lakeland, FL 33801-4983 - Phone
- (863) 937-2430
- NPI assigned
- Nov 8, 2012
- Last updated
- Nov 8, 2012
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 10505 | FL | Primary |
Addresses
Primary practice location
215 E Bay St
2
Lakeland, FL 33801-4983
Mailing address
1633 Village Center Dr
306
Lakeland, FL 33803-2870
Phone (863) 937-2430
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jul 1, 2024 through Jul 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10505 | FL | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1352332800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1352332800000",
"number": "1447504733",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1633 VILLAGE CENTER DR",
"address_2": "306",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338032870",
"telephone_number": "863-937-2430"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "215 E BAY ST",
"address_2": "2",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338014983",
"telephone_number": "863-937-2430"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERNANDEZ",
"first_name": "DAVID",
"middle_name": "A",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-11-08",
"last_updated": "2012-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "10505",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakeland, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2012; 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.