Marisa Hendron, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY0759 Issued in NV

Practice address

1820 E. Warm Springs Rd
Suite 115
Las Vegas, NV 89119-4680

Phone

(702) 263-0094

NPI assigned

May 15, 2012

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

Credentials

Doctor of Philosophy

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.

• Nicole Ann Cavenagh, PHD, LLC

  • Clinical Child & Adolescent Psychologist
  • Las Vegas, NV
  • NPI 1639822109
  NPD (past)
• Nicole Ann Cavenagh, PHD, LLC

  • Clinical Neuropsychologist
  • Las Vegas, NV
  • NPI 1841969383
  NPD (past)

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

{
    "created_epoch": "1337040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455926400000",
    "number": "1124387816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3211 E WARM SPRINGS RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891203157",
            "telephone_number": "702-912-5848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1820 E. WARM SPRINGS RD",
            "address_2": "SUITE 115",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891194680",
            "telephone_number": "702-263-0094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRON",
        "first_name": "MARISA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-15",
        "last_updated": "2016-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "NV",
            "license": "PY0759",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NV",
            "license": "PY0759",
            "primary": true
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NV",
            "license": "PY0759",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kamolrat Hendrix, RN
• Mitzie Hendrix
• Stephen John Hendrix
• Steven W Hendrix
• Tiffany Marie Hendrix, PA
• Danielle Tara Hendry
• Keith Heng
• Rose Elizabeth Heng
• Toni Ann Henke
• Dorothy Henley

• Psychologist in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Psychologist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2016; 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.