Laura Herzog

Primary specialty

Social WorkerTaxonomy code 104100000X

License

SW141689 Issued in PA

Practice address

1528 Walnut St Ste 510
Philadelphia, PA 19102-3606

Phone

(267) 669-0300

NPI assigned

Jun 11, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Ethos Treatment LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • West Chester, PA
  • NPI 1306359906
  NPD (past)

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

{
    "created_epoch": "1718064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1669214508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 SPRING GARDEN ST APT 3F",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191303860",
            "telephone_number": "610-220-9191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1528 WALNUT ST STE 510",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191023606",
            "telephone_number": "267-669-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERZOG",
        "first_name": "LAURA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-11",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "PA",
            "license": "SW141689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Herwick
• Joseph Herzig
• Lia Danielle Herzig
• Flavia Marie Herzog, RD,LDN
• Keith D Herzog, MD
• Robin Aimee Herzog, MSN, CRNP
• Ruth A. Heslin, RN
• Bryan D Hess, MD
• Joanna Lee Hess, PT, DPT, PRC, WCS
• Paul Hess

• Social Worker in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2024; 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.