DR. LARRY P HENDERSON (NPI# 1801019302) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1801019302 |
Entity Type | Individual |
Full Name | DR. LARRY P HENDERSON |
Credential | DMIN |
Practice Address |
1100 Bob Courtway Dr Suite 9 Conway AR 72032-4766 |
Mailing Address |
Po Box 845 Mayflower AR 72106-0845 |
Practice Telephone | 5013285525 |
Mailing Telephone | 5013285525 |
Enumeration Date | 2007-04-11 |
Last Update Date | 2007-07-08 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
X | 101YP1600X |
Counselor Specialization: Pastoral |
P9005009 | AR | Behavioral Health & Social Service Providers |
X | 101YP2500X |
Counselor Specialization: Professional |
P9005009 | AR | Behavioral Health & Social Service Providers |
X | 106H00000X | Marriage & Family Therapist | M9712037 | AR | Behavioral Health & Social Service Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1710399084 | Larry Henderson | Early Intervention Provider Agency | 5100 Obannon Dr Apt 78, Las Vegas, NV 89146 | 2014-05-21 |
1215976022 | Larry A Henderson Jr. | Family Medicine | 92 Ratliff St, Lucedale, MS 39452-6537 | 2006-06-06 |
1699105643 | Larry Henderson | Physician Assistant | 1426 Canyon Ave Ne, Live Oak, FL 32064-4832 | 2013-11-12 |
Street Address |
1100 BOB COURTWAY DR SUITE 9 |
City | CONWAY |
State | AR |
Zip Code | 72032-4766 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1912022096 | Maxus | Counselor | 1100 Bob Courtway Dr, Suite 9, Conway, AR 72032-4766 | 2007-03-20 |
1972918084 | Nakeia Guiden | Case Manager/Care Coordinator | 1100 Bob Courtway Dr, Suite 9, Conway, AR 72032-4766 | 2014-06-26 |
1679988786 | Darryl Foster | Case Manager/Care Coordinator | 1100 Bob Courtway Dr, Conway, AR 72032-4766 | 2014-06-26 |
1568886828 | Mary Dorsey | Case Manager/Care Coordinator | 1100 Bob Courtway Dr, Suite 9, Conway, AR 72032-4766 | 2014-02-06 |
1417388307 | Harriella Alcorn Wright | Case Manager/Care Coordinator | 1100 Bob Courtway Dr, Suite 100, Conway, AR 72032-4766 | 2013-12-03 |
1932536471 | Amir Rostampout | Counselor | 1100 Bob Courtway Dr, Conway, AR 72032-4766 | 2013-09-30 |
1225478431 | Jordan Bullock | Case Manager/Care Coordinator | 1100 Bob Courtway Dr, Suite 9, Conway, AR 72032-4766 | 2013-07-02 |
1083966204 | Amber Michelle Glover | Case Manager/Care Coordinator | 1100 Bob Courtway Dr, Suite 9, Conway, AR 72032-4766 | 2012-10-11 |
1134471311 | Francesca Manette Henderson | Case Manager/Care Coordinator | 1100 Bob Courtway Dr, Suite9, Conway, AR 72032-4766 | 2012-10-11 |
1023373149 | Aaron J Hamister | Case Manager/Care Coordinator | 1100 Bob Courtway Dr, Suite 9, Conway, AR 72032-4766 | 2012-07-05 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1730789843 | Amelia S Lasater | Pharmacist | 1155 Hwy 65n, Conway, AR 72032 | 2020-10-28 |
1619584604 | Danyelle Durocher | Occupational Therapist | 1301 North Museum Rd, Conway, AR 72032 | 2020-09-24 |
1780222174 | Eric Herman Boxnick | Pharmacist | 101 West Oak Street, Conway, AR 72032 | 2019-12-16 |
1932746070 | Habilitation Center, LLC | Psychiatric Residential Treatment Facility | 161 Skunk Hollow Road, Conway, AR 72032 | 2019-12-09 |
1679051668 | Mary Elizabeth Black | Nurse Practitioner | 222 Dave Ward Drive, Conway, AR 72032 | 2018-08-01 |
1275035602 | Conway Dental Center Pllc | Dentist | 1600 E. Oak Street Suite B, Conway, AR 72032 | 2018-03-01 |
1750821625 | Luke Osborne | Physical Therapy Assistant | 1 Thomas Ln, Conway, AR 72032 | 2017-02-27 |
1639620099 | Sam's West, Inc. | Technician/Technologist | 1250 South Amity Rd, Conway, AR 72032 | 2016-10-20 |
1922559343 | Sam's West, Inc. | Durable Medical Equipment & Medical Supplies | 1250 Sourth Amity Rd, Conway, AR 72032 | 2016-10-20 |
1639629108 | Posture Store | Durable Medical Equipment & Medical Supplies | 3900 Dave Ward Dr., Suite 1900-130, Conway, AR 72032 | 2016-10-09 |
Find all providers in zip 72032 |
Taxonomy Code | 101YP1600X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Counselor |
Specialization | Pastoral |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1154813186 | Nancy A Barker | Counselor | 164 Waccamaw Medical Park Dr, Conway, SC 29526-8903 | 2018-06-05 |
1982885927 | Mark R Adams | Counselor | 164 Waccamaw Medical Park Dr, Conway, SC 29526-8903 | 2007-11-19 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1477921690 | Reed Wayne Bellew | Counselor | 1901 Dudley St, Texarkana, AR 71854-6341 | 2015-09-03 |
1154504710 | Keili Adiyah Lumiere | Counselor | 103 E Van Buren, Suite 149, Eureka Springs, AR 72632-3653 | 2007-12-06 |
1497177943 | Christopher Johnson | Counselor | 2806 Ewing Ln, Cabot, AR 72023-2114 | 2014-01-16 |
1225317621 | Med | Counselor | 1604 Merrill Dr, Little Rock, AR 72211-1818 | 2011-08-16 |
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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.