Active NPI
Denise Marie Hundertmark, LSCSW
- Clinical Social Worker
- Garden City, KS
National Provider Identifier
1790050904
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 05614
- Practice address
- 2606 N Fleming St Ste 2
Garden City, KS 67846-3254 - Phone
- (620) 647-4921
- Fax
- (620) 628-2592
- NPI assigned
- Mar 21, 2012
- Sex
- Female
- Sole proprietor
- Yes
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 | 05614 | KS | Primary |
Addresses
Primary practice location
2606 N Fleming St Ste 2
Garden City, KS 67846-3254
Mailing address
2606 N Fleming St Ste 2
Garden City, KS 67846-3254
Phone (620) 647-4921
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200381960C | Medicaid | KS |
Other names 1
- Denise Hernandez
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05614 | KS | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Saint Francis Community Services, Inc. | Social Worker | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Salina, KS
- NPI 1063574499
Social Worker
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1332288000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698969600000",
"number": "1790050904",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2606 N FLEMING ST STE 2",
"city": "GARDEN CITY",
"state": "KS",
"postal_code": "678463254",
"telephone_number": "620-647-4921",
"fax_number": "620-628-2592"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2606 N FLEMING ST STE 2",
"city": "GARDEN CITY",
"state": "KS",
"postal_code": "678463254",
"telephone_number": "620-647-4921",
"fax_number": "620-628-2592"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUNDERTMARK",
"first_name": "DENISE",
"middle_name": "MARIE",
"credential": "LSCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-03-21",
"last_updated": "2023-11-03",
"certification_date": "2023-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": "KS",
"license": "05614",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200381960C",
"state": "KS"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "DENISE",
"last_name": "HERNANDEZ",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Garden City, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.