Lacey Delaine Henderson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

096065 Issued in NY

Practice address

114 5TH Ave FL 2
New York, NY 10011-5611

Phone

(646) 453-6777

NPI assigned

Apr 29, 2024

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1714348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714348800000",
    "number": "1053167247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "319 W 134TH ST APT 1W",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100302718",
            "telephone_number": "713-254-0298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 5TH AVE FL 2",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100115611",
            "telephone_number": "646-453-6777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "LACEY",
        "middle_name": "DELAINE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-29",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "096065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Felipa Messon Henderson, DDS
• Jacqueline A Henderson, PT
• Karlyn Henderson, RN
• Katherine O'Neal Henderson, L.AC
• Korey Andrew Henderson, MD
• Lauren Henderson, MD
• Martha J Henderson, MD
• Maryanne Henderson, NP
• Mica Henderson, LMSW
• Morgan Marie Henderson, RN, BSN

• Clinical Social Worker in New York, NY
• Providers in New York, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2024; 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.