Active NPI
Wendy Rufleth Henderson, LCSW
- Clinical Social Worker
- Plantsville, CT
National Provider Identifier
1033260138
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 001241
- Practice address
- 94 Manor Rd
Plantsville, CT 06479-1302 - Phone
- (860) 919-1596
- Fax
- (860) 426-0480
- NPI assigned
- Jan 15, 2007
- Last updated
- Jul 9, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 001241 | CT | Primary |
Addresses
Primary practice location
94 Manor Rd
Plantsville, CT 06479-1302
Mailing address
94 Manor Rd
Plantsville, CT 06479-1302
Phone (860) 919-1596
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11242707 | Other | CT | CAQH RECREDENTIALING |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001241 | CT | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168819200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1033260138",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "94 MANOR RD",
"city": "PLANTSVILLE",
"state": "CT",
"postal_code": "064791302",
"telephone_number": "860-919-1596",
"fax_number": "860-426-0480"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "94 MANOR RD",
"city": "PLANTSVILLE",
"state": "CT",
"postal_code": "064791302",
"telephone_number": "860-919-1596",
"fax_number": "860-426-0480"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDERSON",
"first_name": "WENDY",
"middle_name": "RUFLETH",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-15",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CT",
"license": "001241",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH RECREDENTIALING",
"identifier": "11242707",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Plantsville, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.