Devin Patricia Henderson, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

149.020216 Issued in IL

Practice address

7617 N Villa Wood LN
Peoria, IL 61614-1588

Phone

(309) 693-8200

NPI assigned

Nov 12, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

• Bloom Wellness Collective, PLLC

  • Clinical Social Worker
  • Peoria Heights, IL
  • NPI 1376498345
  NPD Authorized official
• Rise Centered Therapy PLLC

  • Clinical Social Worker
  • East Peoria, IL
  • NPI 1083572184
  NPD Authorized official
• Joy Miller

  • Professional Counselor
  • Peoria, IL
  • NPI 1740471432
  NPD

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

{
    "created_epoch": "1447286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586304000000",
    "number": "1093188070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7617 N VILLA WOOD LN",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616141588",
            "telephone_number": "309-693-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7617 N VILLA WOOD LN",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616141588",
            "telephone_number": "309-693-8200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1510 W Ottawa Rd",
            "address_purpose": "LOCATION",
            "city": "Paxton",
            "state": "IL",
            "postal_code": "609574090",
            "country_code": "US",
            "telephone_number": "217-379-4302",
            "fax_number": "217-379-4304",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "DEVIN",
        "middle_name": "PATRICIA",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-12",
        "last_updated": "2020-04-08",
        "certification_date": "2020-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "149.020216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gauri Hemgude, MSCPT
• Jewel Kristine Hemmele, LCPC
• Amber Hemminger
• James Killian Hender, DC
• Caleb Graham Henderson, MD
• Heidi Henderson, PA
• Melinda Henderson, C-FNP
• Micah Jayne Henderson, RD, LDN
• Michala Henderson, DO
• Amber Hendricks

• Social Worker in Peoria, IL
• Providers in Peoria, IL by specialty
• Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2020; 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.