Derek Lynn Hefner, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

132697-121 Issued in WI

Practice address

702 N Blackhawk Ave
Madison, WI 53705-3357

Phone

(423) 737-7933

NPI assigned

Jul 21, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Richard Kneip, PH.D., P.C.

  • Community/Behavioral Health Agency
  • Clarkston, MI
  • NPI 1679739700

  IL

  Medicare reassignment NPD

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

{
    "created_epoch": "1658361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724371200000",
    "number": "1457086688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "541 HINMAN AVE APT A2",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602023054",
            "telephone_number": "423-737-7933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 N BLACKHAWK AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537053357",
            "telephone_number": "423-737-7933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEFNER",
        "first_name": "DEREK",
        "middle_name": "LYNN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-07-21",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "11798-123",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "132697-121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaila Marie Heelan, CCC-SLP
• Jesse Heer
• Monica K Hees, NP
• Christa Heffernan, RN
• Leigh Nicole Heffner, PHARMD
• Yash Hegde, MD
• Kari A Hegeman, MD
• Robert B Hegeman, MD
• Vicki L Hegerfeld, DC
• Ted James Hegner, P.A.

• Clinical Social Worker in Madison, WI
• Providers in Madison, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.