Active NPI
Dexter Cruthaim Herda, PH.D., LCSW
- Clinical Social Worker
- Grand Junction, CO
National Provider Identifier
1669623039
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- CSW.00992440
- Practice address
- 515 28 3/4 Rd
Grand Junction, CO 81501-5016 - Phone
- (970) 263-4918
- Fax
- (970) 683-7278
- NPI assigned
- Oct 3, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | CSW.00992440 | CO | Primary |
Addresses
Primary practice location
515 28 3/4 Rd
Grand Junction, CO 81501-5016
Mailing address
715 Horizon Dr Ste 225
Grand Junction, CO 81506-8743
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 992440 | Other | CO | LISENSED SOCIAL WORKER AND PHD PSYCHOLOGY |
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CSW.00992440 | CO | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1222992000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1476403200000",
"number": "1669623039",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "715 HORIZON DR STE 225",
"city": "GRAND JUNCTION",
"state": "CO",
"postal_code": "815068743"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "515 28 3/4 RD",
"city": "GRAND JUNCTION",
"state": "CO",
"postal_code": "815015016",
"telephone_number": "970-263-4918",
"fax_number": "970-683-7278"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERDA",
"first_name": "DEXTER",
"middle_name": "CRUTHAIM",
"name_prefix": "Dr.",
"credential": "PH.D., LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-10-03",
"last_updated": "2016-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CO",
"license": "CSW.00992440",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LISENSED SOCIAL WORKER AND PHD PSYCHOLOGY",
"identifier": "992440",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Grand Junction, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.