Active NPI
Alicia Yvette Henderson, LCSW, PH.D.
- Clinical Social Worker
- New York, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- R048309-1
- Practice address
- 160 W 86TH St
New York, NY 10024-4018 - Phone
- (212) 362-5730
- NPI assigned
- Nov 11, 2008
- Sex
- Female
- Sole proprietor
- No
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 | R048309-1 | NY | Primary |
Addresses
Primary practice location
160 W 86TH St
New York, NY 10024-4018
Mailing address
160 West 86TH Street
New York, NY 10024
Phone (212) 362-5730
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| R048309-1 | Other | NY | LICENSE NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
279 E 3Rd St
New York, NY 10009-7813
Phone (212) 531-7533
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R048309-1 | NY | MD | Clinical Social Worker |
| 048309 | NY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| William F Ryan Community Health Center Inc | Current | Accepting new patients | |
| William F Ryan Community Health Center Inc | Current | Accepting new patients | |
| William F Ryan Community Health Center Inc | Current | Accepting new patients |
Locations
110 W 97th St
New York, NY 10025
Phone (212) 316-7906
110 W 97th St
#0
New York, NY 10025
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H5989
Ownership & related parties
All facility ownership & control disclosures 1
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Ryan Health Midtown Emotional Wellness Center | Federally qualified health center | W-2 Managing Employee | Sep 1, 2022 |
Owned or controlled facilities with NPI records 1
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
dba Ryan Health Midtown Emotional Wellness Center
- Federally Qualified Health Center (FQHC)
- New York, NY
- NPI 1043079064
W-2 Managing Employee
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Federally Qualified Health Center (FQHC)
- New York, NY
- NPI 1851328199
-
dba Ryan Health Midtown Emotional Wellness Center
- Federally Qualified Health Center (FQHC)
- New York, NY
- NPI 1043079064
-
dba Ryan Health Wadsworth
- Federally Qualified Health Center (FQHC)
- New York, NY
- NPI 1265046940
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1226361600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1226966400000",
"number": "1053565598",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "160 WEST 86TH STREET",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10024",
"telephone_number": "212-362-5730"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "160 W 86TH ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100244018",
"telephone_number": "212-362-5730"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDERSON",
"first_name": "ALICIA",
"middle_name": "YVETTE",
"name_prefix": "Dr.",
"credential": "LCSW, PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-11-11",
"last_updated": "2008-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "R048309-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE NUMBER",
"identifier": "R048309-1",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.