Provider Demographics
NPI:1972516458
Name:HENNINGS, NIKESHA C (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:NIKESHA
Middle Name:C
Last Name:HENNINGS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 N CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37130-3636
Mailing Address - Country:US
Mailing Address - Phone:615-893-0770
Mailing Address - Fax:615-904-7057
Practice Address - Street 1:118 N CHURCH ST
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130-3636
Practice Address - Country:US
Practice Address - Phone:615-893-0770
Practice Address - Fax:615-904-7057
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2011-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN60161041C0700X
TN46601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3730393Medicaid
TN103I802024Medicare PIN
TN3730393Medicaid