Active NPI
Tamara Hendershot, MSW
- Social Worker
- Forty Fort, PA
National Provider Identifier
1376748483
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- SW127389
- Practice address
- 1169 Wyoming Ave
Forty Fort, PA 18704-4003 - Phone
- (570) 904-7363
- Fax
- (570) 227-1591
- NPI assigned
- Jun 19, 2007
- Last updated
- May 30, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 | SW127389 | PA | Primary |
Addresses
Primary practice location
1169 Wyoming Ave
Forty Fort, PA 18704-4003
Mailing address
1169 Wyoming Ave
Forty Fort, PA 18704-4003
Phone (570) 904-7363
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 |
|---|---|---|---|
| SW127389 | PA | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thaxton Holistic Wellness Center | Social Worker | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182211200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717027200000",
"number": "1376748483",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1169 WYOMING AVE",
"city": "FORTY FORT",
"state": "PA",
"postal_code": "187044003",
"telephone_number": "570-904-7363",
"fax_number": "570-227-1591"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1169 WYOMING AVE",
"city": "FORTY FORT",
"state": "PA",
"postal_code": "187044003",
"telephone_number": "570-904-7363",
"fax_number": "570-227-1591"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDERSHOT",
"first_name": "TAMARA",
"credential": "MSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-06-19",
"last_updated": "2024-05-30",
"certification_date": "2024-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "PA",
"license": "SW127389",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Forty Fort, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 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.