Individual provider Active NPI

Valerie Henderson, PHD

  • Clinical Psychologist
  • Monona, WI
National Provider Identifier
1073899340
Registry record updated Jan 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3167-57 Issued in WI
Practice address
6400 Gisholt Dr
Ste 209
Monona, WI 53713-4835
Phone
(414) 202-9146
NPI assigned
Oct 31, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Addiction (Substance Use Disorder) Psychologist 103TA0400X
Mental Health Counselor 101YM0800X
Group Psychotherapy Psychologist 103TP2701X
Counselor 101Y00000X
Clinical Psychologist 103TC0700X 3167-57 WI Primary

Addresses

Primary practice location

6400 Gisholt Dr
Ste 209
Monona, WI 53713-4835

Mailing address

6400 Gisholt Dr
Ste 209
Monona, WI 53713-4835
Phone (414) 202-9146

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
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Sankofa Behavioral & Community Health, Inc Addiction (Substance Use Disorder) Current Accepting new patients
Day One Mental Health Services Mental Health Current Accepting new patients

Locations

2810 Crossroads Dr
Ste 4000
Madison, WI 53718
Phone (608) 747-7878

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1320019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453334400000",
    "number": "1073899340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 GISHOLT DR",
            "address_2": "STE 209",
            "city": "MONONA",
            "state": "WI",
            "postal_code": "537134835",
            "telephone_number": "414-202-9146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6400 GISHOLT DR",
            "address_2": "STE 209",
            "city": "MONONA",
            "state": "WI",
            "postal_code": "537134835",
            "telephone_number": "414-202-9146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "VALERIE",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-31",
        "last_updated": "2016-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "3167-57",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monona, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2016; 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.