TINA LUCILLE HENDERSON (NPI# 1831745611) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831745611 |
| Entity Type | Individual |
| Full Name | TINA LUCILLE HENDERSON |
| Credential | PMHNP-BC |
| Practice Address |
1114 E Main St Lebanon VA 24266-5014 |
| Mailing Address |
1981 Scratch Gravel Rd Marion VA 24354-7015 |
| Practice Telephone | 2768835050 |
| Mailing Telephone | 2767804946 |
| Enumeration Date | 2019-08-16 |
| Last Update Date | 2019-08-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 364SP0813X |
Clinical Nurse Specialist Specialization: Psych/Mental Health, Geropsychiatric |
0024178041 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | BOARD OF NURSING | 0024178041 | 01 |
| VA | LICENSE | 0024178041 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174812440 | Tina Henderson | Social Worker | 19 W 34th St, New York, NY 10001-3006 | 2011-04-07 |
| Street Address |
1114 E MAIN ST |
| City | LEBANON |
| State | VA |
| Zip Code | 24266-5014 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013117118 | Highlands Sleep Diagnostics, Inc. | Clinic/Center | 1114 E Main St, Lebanon, VA 24266-5014 | 2007-07-18 |
| 1093878779 | Gregory Chiropractic Health Center P.C. | Chiropractor | 1114 E Main St, Suite 7, Lebanon, VA 24266-5014 | 2006-12-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114541174 | Nextdoor Drug | Pharmacist | 932 W Main St, Lebanon, VA 24266 | 2020-06-04 |
| 1720638661 | Advanced Practice Primary Care, Pllc | Nurse Practitioner | 2336 Coal Tipple Hollow, Lebanon, VA 24266 | 2019-09-12 |
| 1962051763 | Best Life Physical Therapy Inc. | Physical Therapist | 383 Technology Park Drive, Lebanon, VA 24266 | 2019-09-05 |
| 1093361024 | Alexis Rae Carson | Psychologist | 84 Dr Lorraine C. Turner Dr. Russell County Public Scho, Lebanon, VA 24266 | 2019-08-15 |
| 1457821019 | Blue Ridge Medical Management Corporation | Internal Medicine | 71 S Flannagan Ave Suite 81, Lebanon, VA 24266 | 2018-11-27 |
| 1457867202 | Elizabeth Altizer Baker | Speech-Language Pathologist | 84 Lorraine C. Turner Dr., Russell County Public Schools, Lebanon, VA 24266 | 2017-12-15 |
| 1851805683 | Laura Hankins Vencill | Speech-Language Pathologist | Russell County Public Schools, 84 Lorraine C. Turner Dr., Lebanon, VA 24266 | 2017-12-01 |
| 1487168670 | Stacy Nichole Davis | Counselor | 78 Rogers St, Lebanon, VA 24266 | 2017-11-27 |
| 1568976751 | Kelly Elizabeth Smith | Counselor | 216 Gilmer Street, Lebanon, VA 24266 | 2017-11-27 |
| 1659883312 | Sara K Poole | Occupational Therapist | 408 Fields Ave., Lebanon, VA 24266 | 2017-11-02 |
| Find all providers in zip 24266 | ||||
| Taxonomy Code | 364SP0813X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Psych/Mental Health, Geropsychiatric |
| Definition to come... |
Please comment or provide details below to improve the information on TINA LUCILLE 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.