Individual provider Active NPI

Marvin L. Hinz, MSW, LICSW

  • Clinical Social Worker
  • Leavenworth, WA
National Provider Identifier
1609846575
Registry record updated Aug 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LW00008462 Issued in WA
Practice address
144 Cherry St
Leavenworth, WA 98826-1069
Phone
(509) 433-4029
Fax
(509) 823-1664
NPI assigned
Jan 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2014

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 LW00008462 WA Primary

Addresses

Primary practice location

144 Cherry St
Leavenworth, WA 98826-1069

Mailing address

144 Cherry St
Leavenworth, WA 98826-1069
Phone (509) 433-4029

Other identifiers 1

IdentifierTypeStateIssuer
1125327MedicaidWA

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
LW00008462WAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408924800000",
    "number": "1609846575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 CHERRY ST",
            "city": "LEAVENWORTH",
            "state": "WA",
            "postal_code": "988261069",
            "telephone_number": "509-433-4029",
            "fax_number": "509-823-1664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144 CHERRY ST",
            "city": "LEAVENWORTH",
            "state": "WA",
            "postal_code": "988261069",
            "telephone_number": "509-433-4029",
            "fax_number": "509-823-1664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HINZ",
        "first_name": "MARVIN",
        "middle_name": "L.",
        "credential": "MSW, LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-24",
        "last_updated": "2014-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW00008462",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1125327",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leavenworth, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2014; 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.