MS. GEORGEANN THELMA HENDRICKS (NPI# 1659641603) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659641603 |
| Entity Type | Individual |
| Full Name | MS. GEORGEANN THELMA HENDRICKS |
| Credential | LMSW, LISAC |
| Practice Address |
5 San Carlos Ave. San Carlos AZ 85550-9900 |
| Practice Telephone | 9284754875 |
| Practice Fax Number | 9284754880 |
| Mailing Telephone | 9284754875 |
| Mailing Fax Number | 9284754880 |
| Enumeration Date | 2012-01-09 |
| Last Update Date | 2012-01-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
LISAC-10819 | AZ | Behavioral Health & Social Service Providers |
| N | 104100000X | Social Worker | LMSW-11182 | AZ | Behavioral Health & Social Service Providers |
| Street Address |
5 SAN CARLOS AVE. |
| City | SAN CARLOS |
| State | AZ |
| Zip Code | 85550-9900 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821586686 | San Carlos Apache Tribe | Community/Behavioral Health | San Carlos Social Services, 7 San Carlos Avenue, San Carlos, AZ 85550 | 2018-04-27 |
| 1568871762 | Aleksandra J Slaski | Counselor | Building 5 San Carlos Avenue, San Carlos, AZ 85550 | 2014-08-13 |
| 1619237377 | Justin Scott Phelps | Psychologist | 5 San Carlos Blvd., San Carlos, AZ 85550 | 2012-05-29 |
| 1669752622 | Sasha Melisa Latonis | Pharmacist | 208 Cibecue Cir, San Carlos, AZ 85550 | 2011-08-23 |
| 1699060343 | Paul Ray Delgado | Pharmacist | 208 Cibique Circle, San Carlos, AZ 85550 | 2011-06-10 |
| 1639481815 | Carlos Duarte | Family Medicine | 1 Vassar Dr Ne, Usphs Indian Hospital, San Carlos, AZ 85550 | 2010-07-05 |
| 1225355290 | Robert Reed Henley | Psychologist | 5 San Carlos Avenue, San Carlos, AZ 85550 | 2010-04-29 |
| 1912234576 | John Paul Hartman | Naturopath | 238 Seneca, San Carlos, AZ 85550 | 2009-11-03 |
| 1609015148 | Pamela Kay Kloote | Pharmacist | 208 Cibeque Circle, San Carlos, AZ 85550 | 2009-02-06 |
| 1689868317 | Jacqueline Ann Tutt | Licensed Practical Nurse | Skill Center Rd., San Carlos, AZ 85550 | 2007-09-06 |
| Find all providers in zip 85550 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396156006 | Sonia Duggal | Counselor | 23 Sequoia Ct, San Carlos, CA 94070-1613 | 2014-05-15 |
| 1184753378 | Jean S Caron | Counselor | 5 White Mountain Avenue, San Carlos, AZ 85550 | 2007-03-05 |
| 1447387287 | Geraldine King | Counselor | 5 San Carlos Ave, San Carlos, AZ 85550 | 2007-02-28 |
| 1932761715 | Ashley Mackie | Counselor | 1692 El Camino Real, San Carlos, CA 94070-5208 | 2019-07-02 |
| 1386124014 | Bianca J Sandoval | Counselor | 610 Elm St Ste 212, San Carlos, CA 94070-3070 | 2018-08-21 |
| 1336630987 | Emlyn Thomas Bowen IIi | Counselor | 610 Elm St Ste 212, San Carlos, CA 94070-3070 | 2018-05-18 |
| 1245666502 | Leann Victor | Counselor | 5 San Carlos Avenue, San Carlos, AZ 85550-9999 | 2013-09-18 |
| 1508201740 | Susan Lachica | Counselor | #5 San Carlos Ave, San Carlos, AZ 85550-9999 | 2013-05-01 |
| 1285917476 | Sam H Tellez | Counselor | 335 Quarry Rd, San Carlos, CA 94070-6217 | 2011-09-23 |
| 1558642561 | Kelly Ann Casson | Counselor | 335 Quarry Rd, San Carlos, CA 94070-6217 | 2011-09-02 |
| Find all providers in SAN CARLOS | ||||
| City | SAN CARLOS |
| Zip Code | 85550 |
Please comment or provide details below to improve the information on MS. GEORGEANN THELMA HENDRICKS.
| 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.