Provider Demographics
NPI:1568267094
Name:HENSELEIT, LARRY
Entity type:Individual
Prefix:
First Name:LARRY
Middle Name:
Last Name:HENSELEIT
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:84099 533 AVE
Mailing Address - Street 2:
Mailing Address - City:TILDEN
Mailing Address - State:NE
Mailing Address - Zip Code:68781-4762
Mailing Address - Country:US
Mailing Address - Phone:402-640-1116
Mailing Address - Fax:
Practice Address - Street 1:84099 533 AVE
Practice Address - Street 2:
Practice Address - City:TILDEN
Practice Address - State:NE
Practice Address - Zip Code:68781-4762
Practice Address - Country:US
Practice Address - Phone:402-640-1116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-18
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TE1100XBehavioral Health & Social Service ProvidersPsychologistExercise & Sports
No227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered