Tabitha Lynette Henninger

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

2548 E Kenosha St
Broken Arrow, OK 74014-6712

Phone

(918) 355-0993

Fax

(918) 355-0995

NPI assigned

Apr 2, 2025

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 names 1

• Tabitha Lynette Willson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1743552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751932800000",
    "number": "1730983537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2548 E KENOSHA ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740146712",
            "telephone_number": "918-355-0993",
            "fax_number": "918-355-0995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2548 E KENOSHA ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740146712",
            "telephone_number": "918-355-0993",
            "fax_number": "918-355-0995"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1721 S Pecan Ave",
            "address_purpose": "LOCATION",
            "city": "Broken Arrow",
            "state": "OK",
            "postal_code": "740125234",
            "country_code": "US",
            "telephone_number": "918-693-1501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENNINGER",
        "first_name": "TABITHA",
        "middle_name": "LYNETTE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-04-02",
        "last_updated": "2025-07-08",
        "certification_date": "2025-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TABITHA",
            "last_name": "WILLSON",
            "middle_name": "LYNETTE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Donald Ray Helmer Jr.
• Morgan E Helms, LCSW
• Lawanda L Henderson
• Zela J Henderson, PT
• Tiffany M Henley, O.T.A
• Aaron Michael Henningsen, LMT
• Guy Henrion
• Crystal Jones Hensley, PA-C
• Jessica Leann Henson, LPC-CANDIDATE
• Madison B Henson

• Case Manager/Care Coordinator in Broken Arrow, OK
• Providers in Broken Arrow, OK by specialty
• Case Manager/Care Coordinator in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2025; 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.