Jill C Hendrickson, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6683 Issued in OH

Practice address

416 Jackson Street
East Liverpool, OH 43920

Phone

(330) 386-7870

Fax

(330) 382-9075

NPI assigned

Feb 1, 2013

Last updated

Feb 1, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jill.hendrickson.p1@direct.sandy.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Community Action Agency of Columbiana County Inc

  dba CAA Health Center at Lisbon

  • Federally Qualified Health Center (FQHC)
  • Lisbon, OH
  • NPI 1821041401
  Medicare reassignment NPD
• Community Action Agency of Columbiana County Inc

  dba CAA Health, Behavioral Health and Dental Center at Melhorn

  • Federally Qualified Health Center (FQHC)
  • Salineville, OH
  • NPI 1508114893
  NPD
• Community Action Agency of Columbiana County, Inc

  dba CAA Health Center at Salem

  • Federally Qualified Health Center (FQHC)
  • Salem, OH
  • NPI 1356064414
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1359676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359676800000",
    "number": "1083953798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 JACKSON STREET",
            "city": "EAST LIVERPOOL",
            "state": "OH",
            "postal_code": "43920",
            "telephone_number": "330-386-7870",
            "fax_number": "330-382-9075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 JACKSON STREET",
            "city": "EAST LIVERPOOL",
            "state": "OH",
            "postal_code": "43920",
            "telephone_number": "330-386-7870",
            "fax_number": "330-382-9075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRICKSON",
        "first_name": "JILL",
        "middle_name": "C",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-01",
        "last_updated": "2013-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OH",
            "license": "6683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenny Hanson
• Derek Christopher Harshaw, D.O
• Karl Hedderich, D.O.
• Help Hotline Crisis Center, Inc.
• Allyson Hendrickson
• Aaron Joshua Hendrix, MD
• Henry J. Parcinski DO,Facos,LLC
• Julianne Henthorn
• Heritage Valley Medical Group, Inc. (HVMG Richard Beatty)
• Heritage Valley Multispecialty Group, Inc. (HVMG The Heart and Vascular Center East Liverpool)

• Psychologist in East Liverpool, OH
• Providers in East Liverpool, OH by specialty
• Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.