Nicole Delores Henson
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Parkville, MO. Individual provider (NPI-1).
NPI number1013204544
StatusActive
Last updated in NPPESAug 5, 2015
Details
- NPI
- 1013204544
- Entity type
- Individual (NPI-1)
- Name
- Nicole Delores Henson
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jul 5, 2011
- Last updated
- Aug 5, 2015
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 320900000X | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | – | – | Yes |
Practice location
9310 Nw 59th TerParkville, MO 64152-3536
Phone 913-909-5205
Mailing address
9310 Nw 59th TerParkville, MO 64152-3536
Phone 913-909-5205
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Other Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility providers in Parkville, MO
Checking a whole list?
Paste a list of NPIs and get status, record, Medicare enrollment and OIG exclusion for each one. 100 free a day, then from $5 for 5,000. Useful for credentialing, billing and pharmacy claim checks.