Kywina M Henderson Professional Advanced Practice Nursing Corporat

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

KYWINA M HENDERSON PROFESSIONAL ADVANCED PRACTICE NURSING CORPORAT

Practice address

1112 Daniels St Ste 10
Vancouver, WA 98660-3063

Phone

(818) 305-6061

NPI assigned

Sep 22, 2023

Organization subpart

No

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

Authorized official

Name

Kywina Marie Henderson, RN, PMHNPNPI 1609079839

Title

Owner Ceo Pmhnp

Phone

(909) 788-4638

Specialties & licenses 1

Addresses

Other names 1

• All Kynd Behavioral Health & Wellness Doing business as

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kywina Marie Henderson, FNP, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Sherman Oaks, CA
  • NPI 1609079839

  WA

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1695340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729468800000",
    "number": "1548049265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1112 DANIELS ST STE 10",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986603063",
            "telephone_number": "425-728-2721",
            "fax_number": "425-490-6547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1112 DANIELS ST STE 10",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986603063",
            "telephone_number": "818-305-6061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KYWINA M HENDERSON PROFESSIONAL ADVANCED PRACTICE NURSING CORPORAT",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-22",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "KYWINA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER CEO PMHNP",
        "authorized_official_telephone_number": "909-788-4638",
        "authorized_official_credential": "RN, PMHNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "All Kynd Behavioral Health & Wellness",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "All Kynd Behavioral Health & Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nancy Kuzior
• Viktor Kuznetsov, DNP
• Vikchai Tiger Ky, SUDPT
• Brittney Grace Kyle
• Kimberly J Kyro-Bello, PHARMD
• L Katherine Moon
• Corinne Beth La Fors
• Todd Robert La Rock, D.O.
• Jaime Anne La Tona, LH61531731
• Labtran Clinical Laboratories, LLC

• Psychiatric/Mental Health Nurse Practitioner in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.