Stephen William Henneka in Saint Augustine - Clinical
Stephen William Henneka - NPI 1104916428
Stephen William Henneka is a Clinical in Saint Augustine, Florida. Stephen William Henneka practices all healthcare services and medical treatments related to Clinical. The NPI Number for Stephen William Henneka is 1104916428. The last update date is 2015-01-14.
Stephen William Henneka's current location address is 1100 S Ponce De Leon Blvd Ste 1, Saint Augustine, Florida. You can contact this provider via phone number 9048247733 and fax number 9048299768. The mailing address for Stephen William Henneka is 1100 S Ponce De Leon Blvd Ste 1, Saint Augustine, Florida. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Stephen William Henneka |
|---|---|
| Address | 1100 S Ponce De Leon Blvd Ste 1, Saint Augustine, Florida |
| Phone Number | 9048247733 |
| Fax Number | 9048299768 |
| Sole Proprietor | Y |
| Credentials | L.C.S.W. |
NPI Number Detail
| NPI Number | 1104916428 |
|---|---|
| Provider Enumeration Date | 2006-10-15 |
| Last Updated Date | 2015-01-14 |
Provider Mailing Address Detail
| Address | 1100 S Ponce De Leon Blvd Ste 1 |
|---|---|
| City | Saint Augustine |
| State | Florida (FL) |
| Post Code | 320846013 |
| Phone Number | 9048247733 |
| Fax Number | 9048299768 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | SW0002939 |
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Definition: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certif |
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What is the unique identifier code issued to Stephen William Henneka by the Centers for Medicare & Medicaid Services?
The Stephen William Henneka has been assigned the NPI (National Provider Identifier) 1104916428. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Where is the Stephen William Henneka located?
The Stephen William Henneka is located at 1100 S Ponce De Leon Blvd Ste 1, Saint Augustine, FL 320846013.
What is Stephen William Henneka's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Stephen William Henneka is Clinical, and the taxonomy code that categorizes this field of expertise is 1041C0700X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1104916428 to Stephen William Henneka?
The Centers for Medicare & Medicaid Services originally issued the 1104916428 to Stephen William Henneka on 2006-10-15.
When was the information related to Stephen William Henneka most recently updated or refreshed?
The details pertaining to the Stephen William Henneka, including its address, specialty, and other relevant information, were last updated or refreshed on 2015-01-14.
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