Mary Hendershott, L.I.S.W.

Primary specialty

Social WorkerTaxonomy code 104100000X

License

05287 Issued in IA

Practice address

2435 Kimberly Rd
Ste 165S
Bettendorf, IA 52722-3591

Phone

(563) 362-2848

Fax

(563) 888-5160

NPI assigned

Oct 3, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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.

• Family Counseling & Psychology Center P.C.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bettendorf, IA
  • NPI 1083719587
  NPD (past)
• Flaherty Counseling & Consulting Inc

  • Clinical Social Worker
  • Bettendorf, IA
  • NPI 1841733086
  NPD (past)

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563494400000",
    "number": "1407940083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2435 KIMBERLY RD.",
            "address_2": "#165 SOUTH",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "52722",
            "telephone_number": "563-362-2848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2435 KIMBERLY RD",
            "address_2": "STE 165S",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527223591",
            "telephone_number": "563-362-2848",
            "fax_number": "563-888-5160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSHOTT",
        "first_name": "MARY",
        "credential": "L.I.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2019-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IA",
            "license": "05287",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE MEDICARE",
            "identifier": "218643",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "I18118",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0283507",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Health From Within Bettendorf LLC
• Healthwise Chiropractic Center, LLC
• Kathleen Hegg, M.A. CCC-SLP
• Helping Hands Transporting Services,LLC
• Hematology-Oncology Associates of the Quad Cities, PC
• James G Henderson, MD
• Julia Catherine Hensch, MD
• Carla Sue Hermann, TECHNICIAN
• Mark E Hermanson, MD
• Wendy Hermanson, LMT, CLT, CA, OMT

• Social Worker in Bettendorf, IA
• Providers in Bettendorf, IA by specialty
• Social Worker in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2019; 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.