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1528161148 NPI number — ROBERT ANTHONY HERGENROEDER LCSW-S

NPI Number: 1528161148
Health Care Provider/Practitioner: ROBERT ANTHONY HERGENROEDER LCSW-S

Information about “1528161148” NPI (ROBERT ANTHONY HERGENROEDER LCSW-S) exists in 1528161148 in HTML format HTML  |  1528161148 in plain Text format TXT  |  1528161148 in PDF (Portable Document Format) PDF  |  1528161148 in an XML format XML  formats.

NPI Number : 1528161148 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1528161148",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "HERGENROEDER",
    "FirstName": "ROBERT",
    "MiddleName": "ANTHONY",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "LCSW-S",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "401 BRANARD ST FL 2",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "HOUSTON",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "77006-5015",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "713-529-0037",
    "MailingAddressFaxNumber": "713-526-4367",
    "FirstLinePracticeLocationAddress": "401 BRANARD ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "HOUSTON",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "77006-5015",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "713-529-0037",
    "PracticeLocationAddressFaxNumber": "713-526-4367",
    "EnumerationDate": "09/07/2006",
    "LastUpdateDate": "05/03/2022",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "1041C0700X",
        "TaxonomyName": "Clinical Social Worker",
        "LicenseNumber": "29718",
        "LicenseNumberStateCode": "TX",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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