Jeremiah Henderson, | |
1800 Fm 2625 E, Marshall, TX 75672-3793 | |
(903) 263-8485 | |
Not Available |
Full Name | Jeremiah Henderson |
---|---|
Gender | Male |
Speciality | Social Worker - Clinical |
Location | 1800 Fm 2625 E, Marshall, Texas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1265018428 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 63527 (Texas) | Primary |
Entity Name | Supportive Care Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1477895043 PECOS PAC ID: 7719126655 Enrollment ID: O20130625000484 |
Entity Name | Sondermind Provider Network Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1760854442 PECOS PAC ID: 9537572490 Enrollment ID: O20210326001541 |
Entity Name | Grow Healthcare Group Pa |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1245845932 PECOS PAC ID: 3476961368 Enrollment ID: O20220525002138 |
Mailing Address | Practice Location Address |
---|---|
Jeremiah Henderson, 1800 Fm 2625 E, Marshall, TX 75672-3793 Ph: (903) 263-8485 | Jeremiah Henderson, 1800 Fm 2625 E, Marshall, TX 75672-3793 Ph: (903) 263-8485 |
David C Lopez, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 620 S Grove St Ste 105, Marshall, TX 75670 Phone: 903-702-7900 Fax: 903-702-7904 | |
Eva Mollinedo, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 401 N Grove St Ste A, Marshall, TX 75670 Phone: 903-938-7721 Fax: 903-234-1639 |