Individual provider Active NPI

Lar'Mara N. Henderson, , LCSW

  • Clinical Social Worker
  • Chattanooga, TN
National Provider Identifier
1851580104
Registry record updated Sep 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
7654 Issued in TN
Practice address
6401 Shallowford Rd
Chattanooga, TN 37421-5406
Phone
(423) 893-6500
Fax
(888) 892-4390
NPI assigned
Oct 22, 2007
Last updated
Sep 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C006836 NC
Clinical Social Worker 1041C0700X 7654 TN Primary

Addresses

Primary practice location

6401 Shallowford Rd
Chattanooga, TN 37421-5406

Mailing address

Chattanooga VA Outpatient Clinic
6401 Shallowford Road
Chattanooga, TN 37421
Phone (423) 893-6500

Other practice location 1

118 Lee Parkway Dr Ste 180
Chattanooga, TN 37421-1761
Phone (423) 403-4393

Other practice location 2

Womack Army Medical Center
Bldg# 4-3219 2817 Reilly Road
Fort Bragg, NC 28310
Phone (910) 907-6825

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C006836NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Scenic City Counseling Collective PLLC Clinical CurrentSince May 1, 2023 Accepting new patients

Locations

118 Lee Parkway Dr
Ste 180
Chattanooga, TN 37421
Phone (423) 403-4393

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1193011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694044800000",
    "number": "1851580104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CHATTANOOGA VA OUTPATIENT CLINIC",
            "address_2": "6401 SHALLOWFORD ROAD",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "37421",
            "telephone_number": "423-893-6500",
            "fax_number": "800-930-0601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6401 SHALLOWFORD RD",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374215406",
            "telephone_number": "423-893-6500",
            "fax_number": "888-892-4390"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "118 Lee Parkway Dr Ste 180",
            "address_purpose": "LOCATION",
            "city": "Chattanooga",
            "state": "TN",
            "postal_code": "374211761",
            "country_code": "US",
            "telephone_number": "423-403-4393",
            "fax_number": "888-892-4390",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Womack Army Medical Center",
            "address_2": "Bldg# 4-3219 2817 Reilly Road",
            "address_purpose": "LOCATION",
            "city": "Fort Bragg",
            "state": "NC",
            "postal_code": "28310",
            "country_code": "US",
            "telephone_number": "910-907-6825",
            "fax_number": "800-930-0601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "LAR'MARA",
        "middle_name": "N.",
        "name_prefix": "Dr.",
        "credential": ", LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-22",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C006836",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "7654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; 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.