Tylie Shae Henderson
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Kahuku, HI
NPI 1366034878 · NPPES record last updated Feb 5, 2021
Key facts
- NPI
- 1366034878
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- Practice address
- 56-660 Kamehameha Hwy
Kahuku, HI 96731-2210 - Phone
- (801) 822-6716
- NPI assigned
- Feb 5, 2021
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | Yes |
Addresses
Primary practice location
56-660 Kamehameha Hwy
Kahuku, HI 96731-2210
Mailing address
1484 N 950 W
Lehi, UT 84043-1099
Phone (801) 822-6716
Other providers in Kahuku, HI
- Tiffany Kristine Gougeon
- Morris Angus Graham
- Carol Francine Green
- Adney John Harris
- Chelsie Heidt
- Rieke Herrmann Marzouki
- Allison H.K. Higa
- Emma Hippolite
- Danielle Hodges
- Josephine MK Hood
All providers in Kahuku, HI · Addiction (Substance Use Disorder) Counselor in Hawaii
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 5, 2021. 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.