Healthcare Provider Details

I. General information

NPI: 1275483349
Provider Name (Legal Business Name): TARSHA HENDERSON BSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2026
Last Update Date: 01/29/2026
Certification Date: 01/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

71 ORPHANAGE RD
FT MITCHELL KY
41017-3006
US

IV. Provider business mailing address

488 RIFLE LN
ELSMERE KY
41018-2685
US

V. Phone/Fax

Practice location:
  • Phone: 859-500-3782
  • Fax: 855-719-0501
Mailing address:
  • Phone: 859-409-6518
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number101YM0800X
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: