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General NPI Number Information
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NPI Number | 1831527548
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Entity Type | Individual
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Provider Name | SHONTE MARIE HENDERSON REGISTERED NURSE
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Gender | Female
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Dates
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Enumeration Date | 10/16/2013
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Last Update Date | 03/11/2025
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Provider Practice Location Address
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Address Line | 3709 MT HERMON AVE
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City | CLEVELAND
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State | OH
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Zip | 44115-3377
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Country | US
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Telephone | 216-526-9377
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Fax |
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Provider Business Mailing Address
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Address Line | 27440 PINEVIEW DR
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City | WESTLAKE
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State | OH
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Zip | 44145-4421
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Country | US
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Telephone | 216-219-2764
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number | 499860
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 163WA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Registered Nurse
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License Number | 499860
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 163WC1500X
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Taxonomy Name | Community Health Registered Nurse
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License Number | 499860
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | 499860
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License Number State | OH
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Taxonomy #5
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Taxonomy Code | 163WP0807X
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Taxonomy Name | Child & Adolescent Psychiatric/Mental Health Registered Nurse
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License Number | 499860
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License Number State | OH
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Taxonomy #6
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Taxonomy Code | 163WP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Registered Nurse
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License Number | 499860
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License Number State | OH
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Taxonomy #7
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 172A00000X
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Taxonomy Name | Driver
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License Number | RW144016
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License Number State | OH
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Taxonomy #9
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 499860
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License Number State | OH
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