Freddie Hendreson, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

4420 Issued in OK

Practice address

2224 N Owasso Ave
Tulsa, OK 74106-3921

Phone

(918) 587-0180

NPI assigned

May 14, 2011

Sex

Male

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

Enrolled in OK

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

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.

• Sydlyfe Counseling Services, LLC

  • Community/Behavioral Health Agency
  • Tulsa, OK
  • NPI 1154669828
  Medicare reassignment NPD

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

{
    "created_epoch": "1305331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305331200000",
    "number": "1073805677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2224 N OWASSO AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741063921",
            "telephone_number": "918-587-0180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2224 N OWASSO AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741063921",
            "telephone_number": "918-587-0180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRESON",
        "first_name": "FREDDIE",
        "name_prefix": "Mr.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-05-14",
        "last_updated": "2011-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OK",
            "license": "4420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tommy Ray Henderson
• Vernezeia Henderson
• Yurim Jung Henderson
• Kerry Hendren
• Ryan Lane Hendren, M.D.
• Misti Annette Hendrick, BSW
• Carolyn Hendricks
• James Warren Hendricks, M.D.
• Michelle Renee Hendricks, PT
• Randall L. Hendricks, M.D.

• Mental Health Counselor in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Mental Health Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2011; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.