Mary Lisa Henry, PH. D., LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2472 Issued in GA

Practice address

49 A Lenox Pointe
Atlanta, GA 30324

Phone

(404) 869-3707

NPI assigned

Mar 27, 2007

Sex

Female

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jul 1, 2018 through Jul 1, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023136140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1523 EMORY RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303062429",
            "telephone_number": "404-869-3707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 A LENOX POINTE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30324",
            "telephone_number": "404-869-3707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "MARY LISA",
        "name_prefix": "Dr.",
        "credential": "PH. D., LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "2472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keisha Marie Henry, WLS, CWC
• Kelsey Violet Henry, MS, ATC, LAT, CES
• Kierra Henry, CAA
• Lydia Althea Henry, CCC-SLP
• Mary Katherine Henry
• Rhonesia Henry
• Shadeen Rachel Henry
• Sheridan Sims Henry, CNP
• Sommer T Henry, LPC
• Sophia L Henry, LCSW

• Clinical Social Worker in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.