Provider Demographics
NPI:1851580104
Name:HENDERSON, LAR'MARA N (, LCSW)
Entity Type:Individual
Prefix:DR
First Name:LAR'MARA
Middle Name:N
Last Name:HENDERSON
Suffix:
Gender:F
Credentials:, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:CHATTANOOGA VA OUTPATIENT CLINIC
Mailing Address - Street 2:6401 SHALLOWFORD ROAD
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421
Mailing Address - Country:US
Mailing Address - Phone:423-893-6500
Mailing Address - Fax:800-930-0601
Practice Address - Street 1:6401 SHALLOWFORD RD
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-5406
Practice Address - Country:US
Practice Address - Phone:423-893-6500
Practice Address - Fax:888-892-4390
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-22
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0068361041C0700X
TN76541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical