Individual provider Active NPI

Carla Hershman, LICSW

  • Clinical Social Worker
  • Mercer Island, WA
National Provider Identifier
1871990135
Registry record updated Dec 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
00008845 Issued in WA
Practice address
2955 80TH Ave SE Ste 206
Mercer Island, WA 98040-2975
Phone
(206) 816-9555
NPI assigned
Dec 1, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 00008845 WA Primary

Addresses

Primary practice location

2955 80TH Ave SE Ste 206
Mercer Island, WA 98040-2975

Mailing address

2955 80TH Ave SE Ste 206
Mercer Island, WA 98040-2975

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

LicenseStateTypeSpecialty
00008845WAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1417392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417392000000",
    "number": "1871990135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2955 80TH AVE SE STE 206",
            "city": "MERCER ISLAND",
            "state": "WA",
            "postal_code": "980402975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2955 80TH AVE SE STE 206",
            "city": "MERCER ISLAND",
            "state": "WA",
            "postal_code": "980402975",
            "telephone_number": "206-816-9555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERSHMAN",
        "first_name": "CARLA",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-01",
        "last_updated": "2014-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "00008845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mercer Island, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2014; 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.