Individual provider Active NPI

Tammy E Henderson, LPC

  • Professional Counselor
  • Mount Laurel, NJ
National Provider Identifier
1083265664
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
37PC00957900 Issued in NJ
Practice address
10000 Midatlantic Dr Ste 101E
Mount Laurel, NJ 08054-1504
Phone
(793) 982-2888
NPI assigned
Sep 24, 2019
Last updated
Sep 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 37PC00957900 NJ Primary

Addresses

Primary practice location

10000 Midatlantic Dr Ste 101E
Mount Laurel, NJ 08054-1504

Mailing address

4800 N Scottsdale Rd Ste 2500
Scottsdale, AZ 85251-7630

Other practice location 1

1873 Marlton Pike E Ste 2-C
Cherry Hill, NJ 08003-2012
Phone (732) 982-2888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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

Enrollment IDStateProvider typePAC IDDetails
I20240319004172 NJ Practitioner - Mental Health Counselor 5193162683 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
New Jersey Behavioral Health PCGroup PAC ID 4284001025, 127 clinicians

Practice addresses (Care Compare)

10000 Midlantic Dr
Suite 101E
Mount Laurel, NJ 08054-1504
Phone (732) 982-2888

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
PHC of Buffalo Grove Clinical Psychology CurrentSince Sep 1, 2023 Accepting new patients
New Jersey Behavioral Health P.C CurrentSince Feb 6, 2024 Accepting new patients
The Artemis Center for Guidance Professional PastSince Sep 1, 2019 Accepting new patients

Locations

4800 N Scottsdale Rd
Ste 2500
Scottsdale, AZ 85251
Phone (253) 346-0392

175 E Hawthorne Pkwy
Ste 235
Vernon Hills, IL 60061
Phone (847) 865-4125

1873 Marlton Pike E
Ste 2-C
Cherry Hill, NJ 08003

10000 Midlantic Dr
Ste 101E
Mount Laurel, NJ 08054
Phone (855) 760-2933

88 Princeton Hightstown Rd
Ste 202
West Windsor, NJ 08550
Phone (609) 497-3300

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.tammyhenderson@148376.advancedmd-direct.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1569283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1083265664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 N SCOTTSDALE RD STE 2500",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852517630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 MIDATLANTIC DR STE 101E",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080541504",
            "telephone_number": "793-982-2888"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1873 Marlton Pike E Ste 2-C",
            "address_purpose": "LOCATION",
            "city": "Cherry Hill",
            "state": "NJ",
            "postal_code": "080032012",
            "country_code": "US",
            "telephone_number": "732-982-2888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "TAMMY",
        "middle_name": "E",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-24",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": "37PC00957900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Laurel, NJ

Sources for this page

Verify at the official NPI Registry.