JACQUELINE HENDRICKS (NPI# 1902451792) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902451792 |
| Entity Type | Individual |
| Full Name | JACQUELINE HENDRICKS |
| Practice Address |
4525 Dean Martin Dr Unit 501 Las Vegas NV 89103-8107 |
| Practice Telephone | 9045047234 |
| Mailing Telephone | 9045047234 |
| Enumeration Date | 2019-08-07 |
| Last Update Date | 2019-08-07 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 405300000X | Prevention Professional | 251268 | FL | Other Service Providers |
| Street Address |
4525 DEAN MARTIN DR UNIT 501 |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89103-8107 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043821671 | New Directions LLC | Counselor | 3651 S Lindell Dr, Ste D15 B, Las Vegas, NV 89103 | 2020-08-17 |
| 1396356929 | A-plus Community Counseling Services LLC | Counselor | 3651 S Lindell Dr Ste D15, Las Vegas, NV 89103 | 2020-08-17 |
| 1437798931 | Las Vegas Diagnostic & Treatment LLC | Neuromusculoskeletal Medicine & OMM | Dpm, 5650 W Flamingo Rd Ste A, Las Vegas, NV 89103 | 2019-12-31 |
| 1033769385 | Maria Yemi Centeno | Technician | 4674 Via Torino, Las Vegas, NV 89103 | 2019-09-18 |
| 1750847869 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 3821 W Flamingo Rd, Las Vegas, NV 89103 | 2019-02-13 |
| 1447741905 | Adgold Medical Corp | Durable Medical Equipment & Medical Supplies | 3651 Lindell Rd Ste D536, Las Vegas, NV 89103 | 2018-05-21 |
| 1184138620 | Kiley Ballew | Social Worker | 4425 South Jones, Suite D3, Las Vegas, NV 89103 | 2017-11-20 |
| 1396275988 | Karen Walton | Technician | 5419 W. Tropicana Ave. A2803, Las Vegas, NV 89103 | 2017-06-15 |
| 1760923643 | Shannon-dorothy Austria | Social Worker | 4425 S. Jones, Suite D3, Las Vegas, NV 89103 | 2017-03-13 |
| 1306260583 | Ladonna Smith | Behavioral Analyst | 1126 Tamerck Ave, Las Vegas, NV 89103 | 2014-02-10 |
| Find all providers in zip 89103 | ||||
| Taxonomy Code | 405300000X |
| Grouping | Other Service Providers |
| Classification | Prevention Professional |
| Prevention Professionals work in programs aimed to address specific patient needs, such as suicide prevention, violence prevention, alcohol avoidance, drug avoidance, and tobacco prevention. The goal of the program is to reduce the risk of relapse, injury, or re-injury of the patient. Prevention Professionals work in a variety of settings and provide appropriate case management, mediation, referral, and mentorship services. Individuals complete prevention professionals training for the population of patients with whom they work. |
| Notes: Source: National Uniform Claim Committee, 2015 [1/1/2016: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316593940 | Ronald Parker | Prevention Professional | 499 Sierra Vista Dr Apt 6, Las Vegas, NV 89169-2754 | 2019-08-09 |
| 1588105530 | Jessica Dawn Harty | Prevention Professional | 6299 Tillman Crest Ave, Las Vegas, NV 89139-6868 | 2017-03-10 |
| 1780120642 | Stacey Dillree | Prevention Professional | 2800 W Sahara Ave Ste 8b-c, Las Vegas, NV 89102-4390 | 2017-01-16 |
| 1710593223 | Changing Lives LLC | Prevention Professional | 500 N Rainbow Blvd Ste 300, Las Vegas, NV 89107-1061 | 2020-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720611304 | Life Changes, Inc. | Prevention Professional | 1195 Kings Row, Reno, NV 89503-3524 | 2020-02-21 |
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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.