Individual provider Active NPI

Javin-Machaias Hintz, MSW, LICSW, LCSW

  • Clinical Social Worker
  • Stillwater, MN
National Provider Identifier
1578230165
Registry record updated Jun 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
9594 Issued in WI
Practice address
225 2ND St N Ste 105
Stillwater, MN 55082-5000
Phone
(608) 630-2736
NPI assigned
Aug 23, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 25387 MN
Clinical Social Worker 1041C0700X 9594 WI Primary

Addresses

Primary practice location

225 2ND St N Ste 105
Stillwater, MN 55082-5000

Mailing address

PO Box 664
River Falls, WI 54022-0664
Phone (651) 560-3139

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
25387MNMDClinical Social Worker
9594WIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1629676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655942400000",
    "number": "1578230165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 664",
            "city": "RIVER FALLS",
            "state": "WI",
            "postal_code": "540220664",
            "telephone_number": "651-560-3139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 2ND ST N STE 105",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550825000",
            "telephone_number": "608-630-2736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HINTZ",
        "first_name": "JAVIN-MACHAIAS",
        "credential": "MSW, LICSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-23",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "25387",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "9594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stillwater, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2022; 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.