Active NPI
Lasonja Henry
- Social Worker
- Pine Bluff, AR
National Provider Identifier
1225409659
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 7721-M
- Practice address
- 620 S Laurel St
Pine Bluff, AR 71601-4859 - Phone
- (870) 534-4900
- NPI assigned
- Oct 12, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 7721-M | AR | Primary |
Addresses
Primary practice location
620 S Laurel St
Pine Bluff, AR 71601-4859
Mailing address
620 S Laurel St
Pine Bluff, AR 71601-4859
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 180635526 | Medicaid | AR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7721-M | AR | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1444608000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1444608000000",
"number": "1225409659",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "620 S LAUREL ST",
"city": "PINE BLUFF",
"state": "AR",
"postal_code": "716014859"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "620 S LAUREL ST",
"city": "PINE BLUFF",
"state": "AR",
"postal_code": "716014859",
"telephone_number": "870-534-4900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENRY",
"first_name": "LASONJA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-10-12",
"last_updated": "2015-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "AR",
"license": "7721-M",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "180635526",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pine Bluff, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.