THEODORE HENDRICKSON (NPI# 1699336073) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699336073 |
| Entity Type | Individual |
| Full Name | THEODORE HENDRICKSON |
| Practice Address |
43 Robert Ln Fairfield CT 06824-2918 |
| Practice Telephone | 2032092180 |
| Mailing Telephone | 2032092180 |
| Enumeration Date | 2019-06-26 |
| Last Update Date | 2019-06-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
102729 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
43 ROBERT LN |
| City | FAIRFIELD |
| State | CT |
| Zip Code | 06824-2918 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942819826 | Lauren J Cotton | Student in an Organized Health Care Education/Training Program | 1073 North Benson Road, Fairfield, CT 06824 | 2020-07-28 |
| 1831652064 | Seagull Counseling & Therapy LLC | Social Worker | 35 Nutmeg Lane, Fairfield, CT 06824 | 2019-04-14 |
| 1871018390 | Richard Matthew Carraway | Nurse Practitioner | 117 Carlynn Drive, Fairfield, CT 06824 | 2017-08-05 |
| 1811426695 | Fairfield County Health & Wellness Services II LLC | Psychiatry & Neurology | 325 Reef Road/suite 109, Fairfield, CT 06824 | 2017-06-06 |
| 1487198214 | Evamarie Koehler Elinskas | Speech-Language Pathologist | 50 Potters Lane, Fairfield, CT 06824 | 2016-12-13 |
| 1447794441 | Nicholas C Kopazna | Counselor | 433 Meadow St, Fairfield, CT 06824 | 2016-12-09 |
| 1245686997 | Tyler Wayne Vitzthum | Chiropractor | 1995 Post Rd., Fairfield, CT 06824 | 2016-05-12 |
| 1184087660 | Beth Segaloff | Social Worker | 191 Catherine Terrace, Fairfield, CT 06824 | 2016-04-01 |
| 1518342781 | April Vanbergen | Counselor | 1275 Post Rd., Suite A5, Fairfield, CT 06824 | 2015-07-29 |
| 1982089181 | Mary Cilio | Social Worker | 173 Samp Mortar Drive, Fairfield, CT 06824 | 2015-07-29 |
| Find all providers in zip 06824 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740813062 | Adenike C. Ogunleye | Nurse Practitioner | California Medical Facility, 1600, California Drive, Fairfield, CA 95687 | 2020-02-14 |
| 1871018390 | Richard Matthew Carraway | Nurse Practitioner | 117 Carlynn Drive, Fairfield, CT 06824 | 2017-08-05 |
| 1689822835 | Ann Marie Fulton | Nurse Practitioner | 640 Glenna Dr, Fairfield, OH 45014-2719 | 2008-08-29 |
| 1609496033 | Angela Dossett | Nurse Practitioner | 301 W Burlington Ave, Fairfield, IA 52556-3242 | 2020-04-27 |
| 1114417854 | Olukemi A Kuku-ojo | Nurse Practitioner | 1234 Empire St Ste 2200, Fairfield, CA 94533 | 2018-05-17 |
| 1083110092 | Laura Petiford Pmhnp, LLC | Nurse Practitioner | 1525 Kings Hwy Ste 206, Fairfield, CT 06824-5321 | 2018-03-30 |
| 1346786704 | Hiedi Lane Arnp, Pllc | Nurse Practitioner | 1101 E Hempstead Ave, Fairfield, IA 52556-3035 | 2017-01-10 |
| 1467994244 | Jeffrey Leininger | Nurse Practitioner | 1234 Empire St Ste 2200, Fairfield, CA 94533-5711 | 2016-11-10 |
| 1528415163 | Angela Saini | Nurse Practitioner | 2101 Courage Dr, Fairfield, CA 94533-6717 | 2016-05-24 |
| 1871861625 | Ryan John Dillon | Nurse Practitioner | 52 Beach Rd, Fairfield, CT 06824-6641 | 2011-12-08 |
| Find all providers in FAIRFIELD | ||||
Please comment or provide details below to improve the information on THEODORE HENDRICKSON.
| 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.