THERESA E HENDERSON (NPI# 1386128205) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386128205 |
| Entity Type | Individual |
| Full Name | THERESA E HENDERSON |
| Credential | CPRP, CRPS |
| Practice Address |
2257 Sandy Ct Orange Park FL 32073-5235 |
| Practice Telephone | 9043142060 |
| Mailing Telephone | 9043142060 |
| Enumeration Date | 2018-09-17 |
| Last Update Date | 2018-09-17 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | FLORIDA BOARD OF CERTIFICATION | 12768 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174960751 | Theresa Ann Henderson | Social Worker | 8810 Rio San Diego Dr., Suite 2200, San Diego, CA 92108 | 2013-05-23 |
| 1699241315 | Theresa A Henderson | Counselor | 165 E Hawthorne Ave, Colville, WA 99114-2629 | 2018-10-19 |
| 1497878177 | Theresa C Henderson | Specialist | 8631 W 3rd St, Suite 815-e, Los Angeles, CA 90048-5901 | 2007-04-09 |
| 1326149014 | Theresa M Henderson | Social Worker | 1210 Millennium Pkwy, Suite 1035, Brandon, FL 33511-4896 | 2006-09-26 |
| 1891762530 | Theresa Henderson | Nurse Practitioner | 1770 E Lake Shore Dr, Suite 207, Decatur, IL 62521-3831 | 2006-03-01 |
| 1699760645 | Theresa S Henderson | Pediatrics | 8244 E Us Highway 36, Suite 210, Avon, IN 46123-9575 | 2005-09-15 |
| Street Address |
2257 SANDY CT |
| City | ORANGE PARK |
| State | FL |
| Zip Code | 32073-5235 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891309423 | Kingsley Endoscopy Center LLC | Clinic/Center | 970 Kingsley Avenue, Orange Park, FL 32073 | 2020-09-01 |
| 1962028688 | Esra Sari | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Avenue., Orange Park Medical Center, Orange Park, FL 32073 | 2020-06-18 |
| 1104441146 | Zeshan Tariq Malik | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Avenue, Office of Graduate Medical Educa, Orange Park, FL 32073 | 2020-06-16 |
| 1902421894 | Ameer Hamza | Student in an Organized Health Care Education/Training Program | 2001, Kingsley Avenue Office of Graduate Medical Educat, Orange Park, FL 32073 | 2020-06-16 |
| 1497378103 | Fawad Ahmed Rashid | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Avenue Office of Graduate Medical Educati, Orange Park, FL 32073 | 2020-05-28 |
| 1477174985 | Hannan Asghar | Student in an Organized Health Care Education/Training Program | Office of Graduate Medical Education 2001 Kingsley, Orange Park, FL 32073 | 2020-05-06 |
| 1902427156 | Emmanuel Iyanuloluwa Morakinyo | Student in an Organized Health Care Education/Training Program | 413 Deer View Avenue, 2001 Kingsley Ave, Orange Park, FL 32073 | 2020-04-29 |
| 1437799327 | Dalande Leger | Behavior Technician | 1563 Kingsley Ave Suite 103, Orange Park, FL 32073 | 2020-01-08 |
| 1215598313 | Mohammad Harisullah Khan | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Ave, Gme Office, Orange Park, FL 32073 | 2019-06-28 |
| 1558927970 | Preetha Kamath | Student in an Organized Health Care Education/Training Program | Orange Park Medical Center, 2001 Kingsley Ave, Orange Park, FL 32073 | 2019-05-10 |
| Find all providers in zip 32073 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164053302 | Shango Husani | Peer Specialist | 2719 Hollywood Blvd Ste B208, Hollywood, FL 33020-4821 | 2020-01-27 |
| 1427698638 | Fire Forged Recovery, Inc | Peer Specialist | 2428 Nw 56th Ave, Lauderhill, FL 33313-3012 | 2020-01-15 |
| 1316584675 | Gainesville Peer Respite, Inc. | Peer Specialist | 728 E. University Avenue, Gainesville, FL 32601 | 2019-12-05 |
| 1639712078 | Josly Quintero | Peer Specialist | 99198 Overseas Hwy Ste 34&5, Key Largo, FL 33037-2437 | 2019-10-17 |
| 1275185993 | Ivanna Rebecca Pengelley | Peer Specialist | 2110 S Gadsden St, Tallahassee, FL 32301-5513 | 2019-07-12 |
| 1134605330 | Cruz Ines Diaz | Peer Specialist | 3400 N- 29th Avenue, Hollywood, FL 33020 | 2018-07-11 |
| 1861900763 | Billing Tech Solutions Corp | Peer Specialist | 10201 Falcon Pine Blvd Apt 208, Orlando, FL 32829-7368 | 2018-01-14 |
| 1184133407 | Cindy Witt | Peer Specialist | 804 3rd St Ste Ab, Neptune Beach, FL 32266-5040 | 2017-09-29 |
| 1649796574 | Robbie Nelson | Peer Specialist | 1817 Se 13th Pl, Gainesville, FL 32641-8395 | 2017-08-22 |
| 1629468376 | Mental Health America of Northeast Florida, Inc. | Peer Specialist | 4615 Philips Hwy Ste 300, Jacksonville, FL 32207-9506 | 2015-02-03 |
| Find all providers with the same taxonomy | ||||
| City | ORANGE PARK |
| Zip Code | 32073 |
Please comment or provide details below to improve the information on THERESA E HENDERSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.