Individual provider Active NPI

Benita Deleon-Hernandez, LCSW

  • Clinical Social Worker
  • Kyle, TX
National Provider Identifier
1467791756
Registry record updated Apr 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
53450 Issued in TX
Practice address
115 Kohlers Xing Ste 330
Kyle, TX 78640-2467
Phone
(512) 878-7401
Fax
(512) 353-0850
NPI assigned
Feb 6, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 53430 TX
Clinical Social Worker 1041C0700X 53450 TX Primary

Addresses

Primary practice location

115 Kohlers Xing Ste 330
Kyle, TX 78640-2467

Mailing address

PO Box 1065
Kyle, TX 78640-1065
Phone (512) 878-7401

Other names 1

  • Bonnie Hernandez Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20150915000649 TX Practitioner - Clinical Social Worker 2466769054 Practice locations: Kyle, TX

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

115 Kohlers Xing
Suite 330
Kyle, TX 78640-2467
Phone (512) 878-7401

PO Box
Suite 1065
Kyle, TX 78640

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
53430TXMDMental Health Counselor
53450TXMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1360108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681689600000",
    "number": "1467791756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1065",
            "city": "KYLE",
            "state": "TX",
            "postal_code": "786401065",
            "telephone_number": "512-878-7401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 KOHLERS XING STE 330",
            "city": "KYLE",
            "state": "TX",
            "postal_code": "786402467",
            "telephone_number": "512-878-7401",
            "fax_number": "512-353-0850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELEON-HERNANDEZ",
        "first_name": "BENITA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-06",
        "last_updated": "2023-04-17",
        "certification_date": "2023-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "53430",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "53450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BONNIE",
            "last_name": "HERNANDEZ",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Kyle, TX

Sources for this page

Verify at the official NPI Registry.