Provider Demographics
NPI:1871332593
Name:INNER COMPASS TASIA HENDERSON NP IN PSYCHIATRY PLLC
Entity type:Organization
Organization Name:INNER COMPASS TASIA HENDERSON NP IN PSYCHIATRY PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TASIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HENDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:914-200-4368
Mailing Address - Street 1:67 HUTCHINSON ST # A
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-7633
Mailing Address - Country:US
Mailing Address - Phone:347-776-2917
Mailing Address - Fax:
Practice Address - Street 1:180 S BROADWAY STE 207
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10605-1845
Practice Address - Country:US
Practice Address - Phone:914-200-4368
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-22
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty