Individual provider Active NPI

Robert W Herndon, LCSW

  • Clinical Social Worker
  • San Marcos, TX
National Provider Identifier
1851395552
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
10538 Issued in TX
Practice address
300 S C M Allen Pkwy Ste 400
San Marcos, TX 78666-6954
Phone
(512) 396-8540
Fax
(512) 396-5680
NPI assigned
Jun 9, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 001911 TX
Clinical Social Worker 1041C0700X 10538 TX Primary

Addresses

Primary practice location

300 S C M Allen Pkwy Ste 400
San Marcos, TX 78666-6954

Mailing address

300 S C M Allen Pkwy Ste 400
San Marcos, TX 78666-6954
Phone (512) 396-8540

Other identifiers 2

IdentifierTypeStateIssuer
00S08EOtherTXBCBS
063960101MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20070320000074 TX Practitioner - Clinical Social Worker 6800999442 Practice locations: San Marcos, TX

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

300 S CM Allen Pkwy
Suite 400
San Marcos, TX 78666-6954
Phone (512) 396-8540

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
001911TXMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1851395552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 S C M ALLEN PKWY STE 400",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "786666954",
            "telephone_number": "512-396-8540",
            "fax_number": "512-396-5680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 S C M ALLEN PKWY STE 400",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "786666954",
            "telephone_number": "512-396-8540",
            "fax_number": "512-396-5680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNDON",
        "first_name": "ROBERT",
        "middle_name": "W",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-09",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "TX",
            "license": "001911",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "10538",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "00S08E",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "063960101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Marcos, TX

Sources for this page

Verify at the official NPI Registry.