Individual provider Active NPI

Michelle Hernandez, LCSW

  • Clinical Social Worker
  • Miami, FL
National Provider Identifier
1487988010
Registry record updated Jun 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
1951 NW 17TH Ave
Miami, FL 33125-1547
Phone
(305) 774-9570
NPI assigned
Sep 30, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Behavior Analyst 103K00000X
Clinical Social Worker 1041C0700X SW13200 FL
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

1951 NW 17TH Ave
Miami, FL 33125-1547

Mailing address

1575 West Ave Apt 2
Miami Beach, FL 33139-2335
Phone (305) 790-7161

Other practice location 1

1575 West Ave
Apt.2
Miami Beach, FL 33139-2386
Phone (305) 790-7161

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20190710000024 FL Practitioner - Clinical Social Worker 6103151444 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dade Family Counseling Community Mental Health Center, Inc CurrentSince Jun 11, 2019 Accepting new patients
Brightside Medical, P.C. Past Accepting new patients

Locations

9350 Sunset Dr
Ste 151
Miami, FL 33173
Phone (786) 548-1022

1951 NW 17th Ave
Miami, FL 33125
Phone (305) 265-9220

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1254268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560297600000",
    "number": "1487988010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1575 WEST AVE APT 2",
            "city": "MIAMI BEACH",
            "state": "FL",
            "postal_code": "331392335",
            "telephone_number": "305-790-7161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1951 NW 17TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331251547",
            "telephone_number": "305-774-9570"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1575 West Ave",
            "address_2": "Apt.2",
            "address_purpose": "LOCATION",
            "city": "Miami Beach",
            "state": "FL",
            "postal_code": "331392386",
            "country_code": "US",
            "telephone_number": "305-790-7161",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "MICHELLE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-30",
        "last_updated": "2019-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW13200",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.