Individual provider Active NPI

Brenda Darlene Hernandez, LSCSW

  • Clinical Social Worker
  • Dodge City, KS
National Provider Identifier
1669133252
Registry record updated Oct 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
06586 Issued in KS
Practice address
2020 Central Ave
Dodge City, KS 67801-6411
Phone
(620) 227-9797
NPI assigned
Jan 5, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 00919 KS
Clinical Social Worker 1041C0700X 06586 KS Primary

Addresses

Primary practice location

2020 Central Ave
Dodge City, KS 67801-6411

Mailing address

PO Box 766
Garden City, KS 67846-0766
Phone (620) 271-7400

Other practice location 1

1700 Avenue F
Dodge City, KS 67801-4541
Phone (620) 225-6821

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20241024002417 KS Practitioner - Clinical Social Worker 7012440381 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00919KSMDAddiction (Substance Use Disorder) Counselor
06586KSMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
United Methodist Western Kansas Mexican-American Ministries, Inc. CurrentSince Oct 1, 2024 Accepting new patients
United Methodist Western Kansas Mexican-American Ministries, Inc. CurrentSince Oct 1, 2024 Accepting new patients

Locations

1700 Avenue F
Dodge City, KS 67801
Phone (620) 225-6821

2020 Central Ave
Dodge City, KS 67801
Phone (620) 227-1371

712A Saint John St
Garden City, KS 67846
Phone (620) 275-1766

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, 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": "1641340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728518400000",
    "number": "1669133252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 766",
            "city": "GARDEN CITY",
            "state": "KS",
            "postal_code": "678460766",
            "telephone_number": "620-271-7400",
            "fax_number": "620-708-4027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 CENTRAL AVE",
            "city": "DODGE CITY",
            "state": "KS",
            "postal_code": "678016411",
            "telephone_number": "620-227-9797"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1700 Avenue F",
            "address_purpose": "LOCATION",
            "city": "Dodge City",
            "state": "KS",
            "postal_code": "678014541",
            "country_code": "US",
            "telephone_number": "620-225-6821",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "BRENDA",
        "middle_name": "DARLENE",
        "name_prefix": "Miss",
        "credential": "LSCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-05",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KS",
            "license": "00919",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "06586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dodge City, KS

Sources for this page

Verify at the official NPI Registry.