Lisa Renee Hendrickson, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

0131000873 Issued in VA

Practice address

107 Woodbridge Dr
Newport News, VA 23608-8211

Phone

(757) 232-4366

NPI assigned

Feb 8, 2013

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1360281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360281600000",
    "number": "1699014712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 WOODBRIDGE DR",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "23608",
            "telephone_number": "757-232-4366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 WOODBRIDGE DR",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236088211",
            "telephone_number": "757-232-4366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRICKSON",
        "first_name": "LISA",
        "middle_name": "RENEE",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-08",
        "last_updated": "2013-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "VA",
            "license": "0131000873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suzette Henahan, CRNA
• Gloria C Henderson, LMT
• Katherine Henderson, PTA
• Kendra Henderson, RBT
• Amir J Hendiani, M.D.
• Ryan Henger, OD
• Jeffrey Layne Henke, MD
• Liliane Lamey Beshay Henna
• Jeffrey Joseph Henneman, MD
• Shannon Henry

• Occupational Therapy Assistant in Newport News, VA
• Providers in Newport News, VA by specialty
• Occupational Therapy Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2013; 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.