MEDICARE: MR. STEPHEN WILLIAM HENNEKA L.C.S.W.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	SW0002939	FL
2	1041C0700X	Clinical Social Worker	SW0002939	FL

General Provider Information

NPI Number	:	1104916428
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. STEPHEN WILLIAM HENNEKA L.C.S.W.

Provider Business Mailing Address
First Line	:	1100 S PONCE DE LEON BLVD STE 1
Second Line	:
City	:	SAINT AUGUSTINE
State	:	FL
Zip	:	32084-6013
Country	:	US
Telephone Number	:	904-824-7733
Fax Number	:	904-829-9768

Provider Business Practice Location Address
First Line	:	1100 S PONCE DE LEON BLVD STE 1
Second Line	:
City	:	SAINT AUGUSTINE
State	:	FL
Zip	:	32084-6013
Country	:	US
Telephone Number	:	904-824-7733
Fax Number	:	904-829-9768

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/15/2006
Last Update Date	:	01/14/2015

Similar Medicare Providers

1063502383 — MR. ANDREW ARNOLD SAPPINGTON III PSYCHOLOGIST
Practice Location Address:

1100 S PONCE DE LEON BLVD STE 1
SAINT AUGUSTINE, FL
32084-6013

Practice Phone: 904-824-7733
Practice Fax: 904-829-9768

1407946726 — MR. DAVID LEROY HACKNEY L.M.H.C.
Practice Location Address:

1100 S PONCE DE LEON BLVD STE 1
SAINT AUGUSTINE, FL
32084-6013

Practice Phone: 904-824-7733
Practice Fax: 904-829-9768

1447333208 — MRS. KAREN GAIL SELIG L.M.F.T.
Practice Location Address:

1100 S PONCE DE LEON BLVD STE 1
SAINT AUGUSTINE, FL
32084-6013

Practice Phone: 904-824-7733
Practice Fax: 904-829-9768

1619050473 — MR. JACK MELVIN MERWIN PSYCHOLOGIST
Practice Location Address:

1100 S PONCE DE LEON BLVD STE 1
SAINT AUGUSTINE, FL
32084-6013

Practice Phone: 904-824-7733
Practice Fax: 904-829-9768

1881290211 — SMILING KIDDS DENTISTRY, P.A.
Practice Location Address:

1100 S PONCE DE LEON BLVD STE 2
SAINT AUGUSTINE, FL
32084-6013

Practice Phone: 904-829-6321
Practice Fax:

1639910649 — AUSTIN TAYLOR OD
Practice Location Address:

1100 S PONCE DE LEON BLVD STE 4
SAINT AUGUSTINE, FL
32084-6013

Practice Phone: 904-824-0212
Practice Fax:

Directions to “ MR. STEPHEN WILLIAM HENNEKA L.C.S.W.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.