Individual provider Active NPI

Heather Devereaux, LMSW

  • Clinical Social Worker
  • Wichita, KS
National Provider Identifier
1952710451
Registry record updated Jan 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
4737 Issued in KS
Practice address
560 N Exposition St
Wichita, KS 67203-5902
Phone
(316) 993-6139
NPI assigned
Aug 8, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 4737 KS Primary
Social Worker 104100000X 9183 KS

Addresses

Primary practice location

560 N Exposition St
Wichita, KS 67203-5902

Mailing address

14118 W Highland Springs CT
Wichita, KS 67235-8060
Phone (316) 993-6139

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20171229001753 KS Practitioner - Clinical Social Worker 4486912144 Practice locations: Wichita, KS

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

560 N Exposition St
Wichita, KS 67203-5902
Phone (316) 993-6139

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9183KSMDSocial Worker
4737KSMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Heather Devereaux, Lscsw, RPT Clinical CurrentSince Apr 16, 2018 Accepting new patients

Locations

560 N Exposition St
Wichita, KS 67203
Phone (316) 264-8317

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.

NPI Registry JSON

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

{
    "created_epoch": "1407456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548633600000",
    "number": "1952710451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14118 W HIGHLAND SPRINGS CT",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672358060",
            "telephone_number": "316-993-6139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 N EXPOSITION ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672035902",
            "telephone_number": "316-993-6139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVEREAUX",
        "first_name": "HEATHER",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-08",
        "last_updated": "2019-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "4737",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "KS",
            "license": "9183",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.