MRS. JACQUELINE SUZANNE HENDRICKSON (NPI# 1912248394) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912248394 |
| Entity Type | Individual |
| Full Name | MRS. JACQUELINE SUZANNE HENDRICKSON |
| Other Name | JACQUELINE ROBERTS |
| Practice Address |
1740 S College Ave Fort Collins CO 80525-1009 |
| Practice Telephone | 9704721207 |
| Mailing Telephone | 9704721207 |
| Enumeration Date | 2013-03-08 |
| Last Update Date | 2013-05-31 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
13683 | CO | Ambulatory Health Care Facilities |
| Y | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
13683 | CO | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922170034 | Jacqueline Ann Hendrickson | Social Worker | 3604 Stonehall Dr, Beltsville, MD 20705-3230 | 2006-11-14 |
| Street Address |
1740 S COLLEGE AVE |
| City | FORT COLLINS |
| State | CO |
| Zip Code | 80525-1009 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003885716 | Ensight Skills Center, Inc. | Optometrist | 1740 S College Ave, Fort Collins, CO 80525-1009 | 2006-03-15 |
| 1700265501 | Amberly R Smith | Marriage & Family Therapist | 1740 S College Ave, Fort Collins, CO 80525-1009 | 2015-05-26 |
| 1437587359 | Cheryl C Refuerzo | Social Worker | 1740 S College Ave, Fort Collins, CO 80525-1009 | 2013-10-31 |
| 1972565430 | Martha Ratliff | Counselor | 1740 S College Ave, Fort Collins, CO 80525-1009 | 2006-04-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356950299 | Kelly Westbrook Schmalstich | Clinical Nurse Specialist | 2020 Blue Yonder Way, Fort Collins, CO 80525 | 2020-07-27 |
| 1912522376 | Tender Gifts Midwifery and Birth Center | Clinical Nurse Specialist | 1817 Jessup Dr Farms, Fort Collins, CO 80525 | 2020-06-11 |
| 1114566015 | Andrea Nicole Brogdon | Acupuncturist | 2501 S. College Ave, Fort Collins, CO 80525 | 2019-12-26 |
| 1013553593 | Kids Overcoming, LLC | Home Health | 1330 Oakridge Drive Suite 105, Fort Collins, CO 80525 | 2019-11-20 |
| 1568019966 | Julia Heithoff | Behavioral Analyst | 1100 Haxton Dr #115, Fort Collins, CO 80525 | 2019-08-20 |
| 1144875246 | Harmony Smiles Dentistry, LLP | Dentist | 356 E Harmony Rd., #6-a, Fort Collins, CO 80525 | 2019-08-06 |
| 1841774502 | Shannon L Harris | Social Worker | 305 Carpenter Road, Fort Collins, CO 80525 | 2018-09-19 |
| 1306332101 | Joshua Evans Brooks | Optometrist | 375 E Horsetooth Rd Bldg 5 Ste 201, Fort Collins, CO 80525 | 2018-07-03 |
| 1285120212 | Danae Fuqua | Physical Medicine & Rehabilitation | Covell Care & Rehabilitation, 2350 Limon Dr., Fort Collins, CO 80525 | 2018-07-02 |
| 1528552890 | Megan E Locke | Audiologist | 724 Whalers Way Bdg I, Suite 101, Fort Collins, CO 80525 | 2018-06-19 |
| Find all providers in zip 80525 | ||||
| Taxonomy Code | 261QM0855X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adolescent and Children Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124659206 | Oasis for Change, LLC | Clinic/Center | 439 Stoney Brook Rd, Fort Collins, CO 80525-8705 | 2020-01-28 |
| 1265055461 | Wholeness Health, LLC | Clinic/Center | 2620 E Prospect Rd Ste 190, Fort Collins, CO 80525-9098 | 2020-05-21 |
| 1073971685 | Harris R. Jensen, Md, LLC | Clinic/Center | 3500 John F Kennedy Pkwy, Suite 210, Fort Collins, CO 80525-2635 | 2016-02-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053933135 | Sandstone Care Cos, LLC | Clinic/Center | 5731 N Academy Blvd, Colorado Springs, CO 80918-3684 | 2020-05-12 |
| 1043831886 | Valtina, LLC | Clinic/Center | 7405 W Us Highway 50 Ste 105, Salida, CO 81201-9354 | 2020-05-04 |
| 1215575147 | Greeley Family Counseling | Clinic/Center | 1122 9th St Ste 201, Greeley, CO 80631-3277 | 2019-12-10 |
| 1881235539 | New Visions Recovery Solutions | Clinic/Center | 225 Cheyenne Blvd, Colorado Springs, CO 80905-2521 | 2019-10-03 |
| 1609426386 | Sandstone Care Colorado, LLC | Clinic/Center | 7555 E Hampden Ave Ste 103, Denver, CO 80231-4832 | 2019-09-16 |
| 1063066579 | Seity, LLC | Clinic/Center | 323 3rd Ave Ste 200, Longmont, CO 80501-5969 | 2019-08-01 |
| 1588141451 | Datg LLC | Clinic/Center | 950 N Logan St Ste 301, Denver, CO 80203-3009 | 2018-07-24 |
| 1447746680 | Healing Rock Counseling, LLC | Clinic/Center | 5100 E Warren Ave Apt D, Denver, CO 80222-5135 | 2018-07-10 |
| 1174072672 | Kady Williams LLC | Clinic/Center | 147 S Rancho Vista Dr, Pueblo, CO 81007-4047 | 2016-09-25 |
| 1619300720 | Dynamic Directions Counseling Inc | Clinic/Center | 7000 S Broadway Ste 1a, Centennial, CO 80122-1064 | 2013-08-12 |
| Find all providers with the same taxonomy | ||||
| City | FORT COLLINS |
| Zip Code | 80525 |
Please comment or provide details below to improve the information on MRS. JACQUELINE SUZANNE 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.