MEDICARE: ALLISON HENDRICKSON MSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	ISW13425	FL
2	1041C0700X	Clinical Social Worker	20709	FL

General Provider Information

NPI Number	:	1245715721
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLISON HENDRICKSON MSW

Provider Business Mailing Address
First Line	:	200 N EDGEMON AVE
Second Line	:
City	:	WINTER SPRINGS
State	:	FL
Zip	:	32708-2525
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 N EDGEMON AVE
Second Line	:
City	:	WINTER SPRINGS
State	:	FL
Zip	:	32708-2525
Country	:	US
Telephone Number	:	786-247-5574
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/01/2018
Last Update Date	:	03/25/2025

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