Individual provider Active NPI

Beatriz Gisselle Baella Hernandez, LCSW

  • Clinical Social Worker
  • Tallahassee, FL
National Provider Identifier
1578765111
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW 8676 Issued in FL
Practice address
2888 Mahan Dr Ste 1
Tallahassee, FL 32308-5465
Phone
(850) 443-1974
NPI assigned
Jun 5, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW 8676 FL Primary

Addresses

Primary practice location

2888 Mahan Dr Ste 1
Tallahassee, FL 32308-5465

Mailing address

7101 Sleepy Holw
Tallahassee, FL 32312-7563
Phone (850) 443-1974

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW 8676FLMDClinical Social Worker

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1578765111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7101 SLEEPY HOLW",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323127563",
            "telephone_number": "850-443-1974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2888 MAHAN DR STE 1",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323085465",
            "telephone_number": "850-443-1974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAELLA HERNANDEZ",
        "first_name": "BEATRIZ",
        "middle_name": "GISSELLE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW 8676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.