Latundra Henderson, LISW, LICDC is a medicare enrolled "Social Worker - Clinical" provider in Mentor, Ohio. Her current practice location is
7232 Justin Way, Mentor, Ohio. You can reach out to her office (for appointments etc.) via phone at
(440) 578-8200.
Latundra Henderson is licensed to practice in Ohio (license number I.2002418-SUPV) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1326599663.
Healthcare Provider's Profile
Full Name | Latundra Henderson |
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Gender | Female |
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Speciality | Social Worker - Clinical |
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Location | 7232 Justin Way, Mentor, Ohio |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1326599663
- Provider Enumeration Date: 10/21/2016
- Last Update Date: 01/28/2022
Medicare PECOS Information:
- PECOS PAC ID: 0143632893
- Enrollment ID: I20201222001003
Medical Identifiers
Medical identifiers for Latundra Henderson such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1326599663 | NPI | - | NPPES |
0423502 | Medicaid | OH | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YA0400X | Counselor - Addiction (substance Use Disorder) | LICDC161330 (Ohio) | Secondary |
106H00000X | Marriage & Family Therapist | S1600147 (Ohio) | Secondary |
1041C0700X | Social Worker - Clinical | I.2002418-SUPV (Ohio) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Latundra Henderson allows following entities to bill medicare on her behalf.
Entity Name | Signature Health, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1679767289 PECOS PAC ID: 8628970985 Enrollment ID: O20040126000762 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Latundra Henderson is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Latundra Henderson, LISW, LICDC 7232 Justin Way, Mentor, OH 44060-4881 Ph: (440) 578-8200 | Latundra Henderson, LISW, LICDC 7232 Justin Way, Mentor, OH 44060-4881 Ph: (440) 578-8200 |
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