Jada Hendrickson

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC-0018310 Issued in CO

Practice address

212 E Monument St
Colorado Springs, CO 80903-1004

Phone

(303) 483-3930

NPI assigned

Apr 13, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Jada Carr Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Resilience Rewired Therapy and Neurofeedback, LLC

  • Mental Health Counselor
  • Colorado Springs, CO
  • NPI 1962257329

  Addiction (Substance Use Disorder)

  NPD Authorized official

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

{
    "created_epoch": "1586736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1659990323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 E MONUMENT ST",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809031004",
            "telephone_number": "303-483-3930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 E MONUMENT ST",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809031004",
            "telephone_number": "303-483-3930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRICKSON",
        "first_name": "JADA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-13",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "LPC-0018310",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CO",
            "license": "0109918",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JADA",
            "last_name": "CARR",
            "credential": "LPC, LAC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Jason Tyler Hendricks, PA-C
• Jerry Allen Hendricks, O.D.
• Laura Ef Hendricks, NP
• Rush Davis Hendricks, DPT
• Austin Hendrickson, LPC
• Ben Gerard Hendriks, P.T.
• Alannah Hendrix
• Danielle Hendrix
• Hannah Hendrix
• Rex Asher Henegar, DDS

• Professional Counselor in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Professional Counselor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 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.

Verify at the official NPI Registry.