DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: LISA HENDERSON

MEDICARE: LISA HENDERSON
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
1101YA0400XAddiction (Substance Use Disorder) Counselor8479511-6006UT
2172V00000XCommunity Health Worker

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11104119619OTHERMENTAL HEALTH INTERN

General Provider Information

NPI Number : 1528439387
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA HENDERSON
Provider Business Mailing Address
First Line : 6013 S REDWOOD RD
Second Line :
City : TAYLORSVILLE
State : UT
Zip : 84123-5220
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 35 SKYLINE DR
Second Line :
City : BRIGHAM CITY
State : UT
Zip : 84302-6772
Country : US
Telephone Number : 801-255-5131
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/19/2015
Last Update Date : 05/18/2023

Similar Medicare Providers

1801823620 — DR. JASON P BLOCK MD
Practice Location Address:
75 FRANCIS STREET , BRIGHAM INTERNAL MEDICARE ASSOCIATES
BOSTON, MA
02115
Practice Phone: 617-732-6049
Practice Fax: 617-264-5202
1598082703 — DAVID M PICKETT DC
Practice Location Address:
35 SKYLINE DR
BRIGHAM CITY, UT
84302-6772
Practice Phone: 801-255-5131
Practice Fax:
1477405447 — MARTIN JI
Practice Location Address:
35 SKYLINE DR
BRIGHAM CITY, UT
84302-6772
Practice Phone: 801-255-5131
Practice Fax:
1225988769 — KIRA BLANCHARD-ARAVE
Practice Location Address:
35 SKYLINE DR
BRIGHAM CITY, UT
84302-6772
Practice Phone: 801-255-5131
Practice Fax:
1255634366 — ADAM VOSS
Practice Location Address:
35 SKYLINE DR
BRIGHAM CITY, UT
84302-6772
Practice Phone: 801-255-5131
Practice Fax:
1124569645 — KEELY MAJOR
Practice Location Address:
35 SKYLINE DR
BRIGHAM CITY, UT
84302-6772
Practice Phone: 801-255-5131
Practice Fax:

Directions to “ LISA HENDERSON ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.