Individual
MS. ELIZABETH E M HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSCSW
Contact information
Practice address
200 MAINE ST STE A, BERT NASH COMMUNITY MENTAL HEALTH CENTER, LAWRENCE, KS 66044-1396
(785) 843-9192
(785) 843-9192
Mailing address
1802 W 5TH ST, APT 3, LAWRENCE, KS 66044-4638
(785) 304-9121
(785) 304-9121
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LSCSW 2085
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
069328HE
BCBS
KS
05
—
200430750B
—
KS
Enumeration date
12/26/2006
Last updated
07/09/2014
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