MRS. JACQUELINE HENDERSON (NPI# 1801131560) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801131560 |
| Entity Type | Individual |
| Full Name | MRS. JACQUELINE HENDERSON |
| Credential | CIT |
| Practice Address |
3204 E Moore Ave Searcy AR 72143-4826 |
| Practice Telephone | 5012687777 |
| Practice Fax Number | 5013055009 |
| Mailing Telephone | 5012687777 |
| Mailing Fax Number | 5013055009 |
| Enumeration Date | 2012-12-06 |
| Last Update Date | 2012-12-06 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366851925 | Jacqueline Henderson | Contractor | 1601 Crabapple Cove Ct N, Jacksonville, FL 32225-2500 | 2014-08-07 |
| 1669035846 | Jacqueline Henderson | Registered Nurse | 1501 Madison Rd, Walnut Hills, OH 45206-1706 | 2019-04-15 |
| 1700382041 | Jacqueline Henderson | Technician | 1215 49th St Ne, Washington, DC 20019-3937 | 2018-04-04 |
| 1851600233 | Jacqueline Henderson | Registered Nurse | 4219 Laclede Ave, Suite B, Saint Louis, MO 63108-2814 | 2010-10-01 |
| 1033366331 | Jacqueline A Henderson | Physical Therapist | 110 E 42nd St, Suite 1504, New York, NY 10017-5611 | 2008-08-19 |
| 1366482358 | Jacqueline Henderson | Emergency Medicine | 301 W Homer St, Michigan City, IN 46360-4358 | 2006-06-07 |
| Street Address |
3204 E MOORE AVE |
| City | SEARCY |
| State | AR |
| Zip Code | 72143-4826 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932234960 | Wilbur D. Mills Treatment Center | Substance Abuse Rehabilitation Facility | 3204 E Moore Ave, Searcy, AR 72143-4826 | 2007-02-22 |
| 1972083806 | Northeast Arkansas Community Mental Health Center Inc | Substance Abuse Rehabilitation Facility | 3204 E Moore Ave, Searcy, AR 72143-4826 | 2018-08-20 |
| 1477953271 | Preferred Family Healthcare Inc | Community/Behavioral Health | 3204 E Moore Ave, Searcy, AR 72143-4826 | 2014-08-28 |
| 1609201110 | Alyssa Dawn Stark | Specialist | 3204 E Moore Ave, Searcy, AR 72143-4826 | 2013-09-04 |
| 1821423328 | Estrellita Jasmin Goss | Specialist | 3204 E Moore Ave, Searcy, AR 72143-4826 | 2013-09-04 |
| 1437581543 | Samantha Yvonne Smith | Licensed Practical Nurse | 3204 E Moore Ave, Searcy, AR 72143-4826 | 2013-07-31 |
| 1639511561 | Derek Chase | Case Manager/Care Coordinator | 3204 E Moore Ave, Searcy, AR 72143-4826 | 2013-07-19 |
| 1043651201 | Lavonda Peters | Case Manager/Care Coordinator | 3204 E Moore Ave, Searcy, AR 72143-4826 | 2013-07-16 |
| 1992146690 | Steven Erchien | Case Manager/Care Coordinator | 3204 E Moore Ave, Searcy, AR 72143-4826 | 2013-07-10 |
| 1376989970 | Tina Renee Hicks | Case Manager/Care Coordinator | 3204 E Moore Ave, Searcy, AR 72143-4826 | 2013-05-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679188874 | Jessalyn Elise Tackett | Pharmacist | 200 E. Race Ave, Searcy, AR 72143 | 2020-09-14 |
| 1528697620 | Edward Lee | Student in an Organized Health Care Education/Training Program | 3214 E Race St, Searcy, AR 72143 | 2020-04-02 |
| 1700420338 | Rebecca Joanne Yauilla | Family Medicine | 3214 Race Avenue, Searcy, AR 72143 | 2019-11-06 |
| 1558913517 | The Forge Counseling Group LLC | Counselor | 505 S Elm St Suite C, Searcy, AR 72143 | 2019-07-10 |
| 1023584620 | Lisa Farley | Speech-Language Pathologist | 2918 Hawkins Drive, Searcy, AR 72143 | 2018-10-22 |
| 1144761719 | Christie Brooks | Dietitian, Registered | 91 Lakeway Drive, Searcy, AR 72143 | 2017-03-16 |
| 1639626112 | Kelly Walls | Pharmacist | 805 E Park Ave, Searcy, AR 72143 | 2016-09-01 |
| 1417316480 | Zach Wickes | Student in an Organized Health Care Education/Training Program | 506 N Van, Searcy, AR 72143 | 2016-02-18 |
| 1982081592 | Bethel Burris Oliver Pllc | Dentist | 3245 E. Race St, Searcy, AR 72143 | 2015-05-04 |
| 1053798116 | Ronnie Harlow | Rehabilitation Practitioner | 1005 East Park, Jim Citty Football and Athletic Training Facility, Searcy, AR 72143 | 2015-04-28 |
| Find all providers in zip 72143 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861838609 | The Regroup, Pllc | Counselor | 103 N Main St, Searcy, AR 72143-5421 | 2013-05-20 |
| 1447531629 | Mary Elizabeth Brand | Counselor | 3204 E Moore St, Searcy, AR 72143-4826 | 2011-09-01 |
| 1992084701 | Jimmy E Dixon | Counselor | 642 North Main St, Searcy, AR 72143 | 2011-08-10 |
| 1740568211 | Rachel Wiles | Counselor | 3204 E Moore St, Searcy, AR 72143-4826 | 2011-08-01 |
| 1801174438 | Blaine Erien Palmer | Counselor | 3204 E Moore Ave, Searcy, AR 72143-4826 | 2011-08-01 |
| 1346528965 | Tanya Stewart | Counselor | 3204 E Moore Ave, Searcy, AR 72143-4826 | 2011-07-31 |
| 1538457551 | Rita Diane Glaze | Counselor | 3204 E Moore St, Searcy, AR 72143-4826 | 2011-07-11 |
| 1760779003 | Brian Emory Whiteside | Counselor | 3204 E Moore Ave, Searcy, AR 72143-4826 | 2011-07-07 |
| 1730476409 | Amanda Walker | Counselor | 3204 E Moore Ave, Searcy, AR 72143-4826 | 2011-07-01 |
| 1679860514 | Keith Franklin Gregson | Counselor | 3204 E Moore St, Searcy, AR 72143-4826 | 2011-06-29 |
| Find all providers in SEARCY | ||||
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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.