Jerly Henriquez, LPCR

Primary specialty

CounselorTaxonomy code 101Y00000X

License

0704016745 Issued in VA

Practice address

10721 Main St Ste 2400
Fairfax, VA 22030-6902

Phone

(703) 270-0225

NPI assigned

Jan 30, 2025

Sex

Female

Sole proprietor

No

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

Enrolled in VA

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.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Columbia Associates in Psychiatry PC

  • Psychiatry Physician
  • Arlington, VA
  • NPI 1699012930
  Medicare reassignment NPD

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

{
    "created_epoch": "1738195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738195200000",
    "number": "1063225225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10721 MAIN ST STE 2400",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220306902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10721 MAIN ST STE 2400",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220306902",
            "telephone_number": "703-270-0225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRIQUEZ",
        "first_name": "JERLY",
        "credential": "LPCR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-30",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "VA",
            "license": "0704016745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Derek C. Henderson
• Nichole Yvonne Henderson
• Michelle Hendrickson, PH.D.
• Esther Henebeng, MD
• Elsie Allen Hennig, LPTA
• Henry Moyle M.D., PHD, PC
• Christina E Henry
• Margaret Ann Henry, AUDIOLOGIST
• Mequeda C Henry
• Rebecca Henry, MSW

• Counselor in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2025; 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.

Verify at the official NPI Registry.