Active NPI
Michael Hendery, PSY.D.
- Clinical Psychologist
- Dover, NH
National Provider Identifier
1003981374
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1179
- Practice address
- 2 Washington St
Suite 314
Dover, NH 03820-3890 - Phone
- (603) 953-5254
- Fax
- (603) 430-3753
- NPI assigned
- Nov 22, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Clinical Psychologist | 103TC0700X | 1179 | NH | Primary |
Addresses
Primary practice location
2 Washington St
Suite 314
Dover, NH 03820-3890
Mailing address
2 Washington St
Suite 314
Dover, NH 03820-3890
Phone (603) 953-5254
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7706655Y0NH01 | Other | NH | BHN |
| 99003227 | Medicaid | NH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- George Washington University School of Medicine, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
426 Middle St
Portsmouth, NH 03801-5017
Phone (603) 953-5254
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1179 | NH | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164153600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1231286400000",
"number": "1003981374",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 WASHINGTON ST",
"address_2": "SUITE 314",
"city": "DOVER",
"state": "NH",
"postal_code": "038203890",
"telephone_number": "603-953-5254",
"fax_number": "603-430-3753"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 WASHINGTON ST",
"address_2": "SUITE 314",
"city": "DOVER",
"state": "NH",
"postal_code": "038203890",
"telephone_number": "603-953-5254",
"fax_number": "603-430-3753"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDERY",
"first_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-22",
"last_updated": "2009-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NH",
"license": "1179",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BHN",
"identifier": "7706655Y0NH01",
"state": "NH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "99003227",
"state": "NH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dover, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.