Larann R Henderson
Individual provider Active NPI Mental Health Counselor · Willits, CA
NPI 1457584062 · NPPES record last updated Jan 20, 2023
Key facts
- NPI
- 1457584062
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 29042 (CA)
- Practice address
- 1940 Clover Dr
Willits, CA 95490-8867 - Phone
- (707) 841-9483
- NPI assigned
- Aug 30, 2009
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
1940 Clover Dr
Willits, CA 95490-8867
Phone (707) 841-9483
245 S Humboldt St
Suite B
Willits, CA 95490-3576
Phone (707) 841-9483
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161208000217 | CA | Practitioner - Clinical Social Worker | 6305126343 |
Reassigns benefits to 2 organizations Practice locations: Willits, CA |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29042 | CA | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Long Valley Health Center | Current |
Accepting new patients | |
| Consolidated Tribal Health Project, Inc. | Current |
Accepting new patients |
Locations
50 Branscomb Rd
Laytonville, CA 95454
Phone (707) 984-6131
6991 N State St
Redwood Vly, CA 95470
Phone (707) 467-5620
Interoperability endpoints
- https://api.platform.athenahealth.com/15156/brand/1/csg/1/fhir/r4
- https://fhir4.healow.com/fhir/r4/AECBBA
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 29042 | CA | |
| Mental Health Counselor | 101YM0800X | 29042 | CA | Yes |
Addresses
Primary practice location
1940 Clover Dr
Willits, CA 95490-8867
Mailing address
1940 Clover Dr
Willits, CA 95490-8867
Other providers in Willits, CA
- Barbra Long Gradus
- Susan Lea Gravier
- Pendry Haines
- Shawna Stuart Handschug
- Miriam Ida Harris
- Amanda Mae Hennes
- Nina Elisa Hoffman
- Eric Woodfin Holden
- Charles Macaulay Hott
- Jesse Jacobson
All providers in Willits, CA · Mental Health Counselor in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 20, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.