Active NPI
Valerie Henderson, PHD
- Clinical Psychologist
- Monona, WI
National Provider Identifier
1073899340
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 3167-57
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Organization | Specialty | Status | New 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.
-
- Mental Health Counselor
- Monona, WI
- NPI 1104543685
-
- Community/Behavioral Health Agency
- Madison, WI
- NPI 1912243288
Addiction (Substance Use Disorder)
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.