Holly Jo Henderson, LPC | |
1701 Townsend St, Cassville, MO 65625-1451 | |
(417) 671-8075 | |
Not Available |
Full Name | Holly Jo Henderson |
---|---|
Gender | Female |
Speciality | Counselor - Professional |
Location | 1701 Townsend St, Cassville, Missouri |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1811389620 | NPI | - | NPPES |
1811389620 | Medicaid | MO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | 2015002776 (Missouri) | Primary |
Entity Name | Clark Community Mental Health Center |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1801807771 PECOS PAC ID: 8527069277 Enrollment ID: O20070123000267 |
Mailing Address | Practice Location Address |
---|---|
Holly Jo Henderson, LPC Po Box 221, Cape Fair, MO 65624-0221 Ph: (417) 559-0135 | Holly Jo Henderson, LPC 1701 Townsend St, Cassville, MO 65625-1451 Ph: (417) 671-8075 |
Rebecca Beagle, PLPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1701 Townsend St, Cassville, MO 65625 Phone: 417-671-8075 | |
Julie May Deines, MSW, CRADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 210 W 8th St, Cassville, MO 65625 Phone: 417-655-5781 | |
Heather Ann Hays, 2014034460 Counselor Medicare: Medicare Enrolled Practice Location: 12716 Farm Road 2239, Cassville, MO 65625 Phone: 417-476-1000 Fax: 417-476-1082 |