Kayla Renne Henderson

Primary specialty

Developmental TherapistTaxonomy code 222Q00000X

License

201172996 Issued in KY

Practice address

12008 W US Highway 60
Olive Hill, KY 41164-8363

Phone

(270) 763-8225

NPI assigned

May 22, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• The Kid Spot Center

  • Speech-Language Pathologist
  • Elizabethtown, KY
  • NPI 1710307152
  NPD (past)

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

{
    "created_epoch": "1495411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706054400000",
    "number": "1114454147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12008 W US HIGHWAY 60",
            "city": "OLIVE HILL",
            "state": "KY",
            "postal_code": "411648363",
            "telephone_number": "270-763-8225",
            "fax_number": "270-283-4894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12008 W US HIGHWAY 60",
            "city": "OLIVE HILL",
            "state": "KY",
            "postal_code": "411648363",
            "telephone_number": "270-763-8225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "KAYLA",
        "middle_name": "RENNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-22",
        "last_updated": "2024-01-24",
        "certification_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": "KY",
            "license": "201172996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frank Lyons DO, PSC
• Larissa Renee Gilbert
• Cindra Lynn Greene, APRN
• Karla Greene
• Angela Hanshaw
• Pamela S Howard, TBVI, ATP
• Debbie Lynn Hudson
• Timothy Scott Huff
• Kevin R. Jordan, DMD
• Journey to Healing

• Developmental Therapist in Olive Hill, KY
• Providers in Olive Hill, KY by specialty
• Developmental Therapist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.