Lisa Dawn Hendrickson, SSW
Individual provider Active NPI Social Worker · Beaver, UT
NPI 1003091109 · NPPES record last updated Jan 8, 2008
Key facts
- NPI
- 1003091109
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 6827333-3503 (UT)
- Practice address
- 75 W 1175 N
Beaver, UT 84713 - Phone
- (435) 438-5537
- Fax
- (435) 438-5170
- NPI assigned
- Jan 8, 2008
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6827333-3503 | UT | MD | Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 6827333-3503 | UT | Yes |
Addresses
Primary practice location
75 W 1175 N
Beaver, UT 84713
Mailing address
474 W 200 N
Suite 300
St George, UT 84770-4505
Phone (435) 634-5600
Other providers in Beaver, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 8, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.