Gregory Henderson, LADC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

00608 Issued in VT

Practice address

39 Fogg Farm Road
Wilder, VT 05088

Phone

(802) 295-1311

Fax

(802) 295-1312

NPI assigned

Dec 3, 2013

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Clara Martin Center

  • Community/Behavioral Health Agency
  • Randolph, VT
  • NPI 1548060015
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1386028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386028800000",
    "number": "1003247958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 N MAIN ST",
            "city": "RANDOLPH",
            "state": "VT",
            "postal_code": "050601126",
            "telephone_number": "802-728-4466",
            "fax_number": "802-728-4197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 FOGG FARM ROAD",
            "city": "WILDER",
            "state": "VT",
            "postal_code": "05088",
            "telephone_number": "802-295-1311",
            "fax_number": "802-295-1312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "GREGORY",
        "credential": "LADC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-12-03",
        "last_updated": "2013-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "VT",
            "license": "00608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dr George J Schuetz
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• Diane M Everett, PT
• Kaitlin George, BA
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• Daniel Paul Roden, LCMHC

• Addiction (Substance Use Disorder) Counselor in Wilder, VT
• Providers in Wilder, VT by specialty
• Addiction (Substance Use Disorder) Counselor in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.