Individual provider Active NPI

Tammy S Henderson, PC

  • Professional Counselor
  • Sandusky, OH
National Provider Identifier
1134471642
Registry record updated Oct 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
C.0900588 Issued in OH
Practice address
1218 Cleveland Rd
Sandusky, OH 44870-4200
Phone
(419) 626-9156
Fax
(419) 621-0099
NPI assigned
Oct 8, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2012

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 C.0900588 OH Primary

Addresses

Primary practice location

1218 Cleveland Rd
Sandusky, OH 44870-4200

Mailing address

1218 Cleveland Rd
Sandusky, OH 44870-4200
Phone (419) 626-9156

Other identifiers 1

IdentifierTypeStateIssuer
2325906MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20240118003258 OH Practitioner - Mental Health Counselor 5092167635 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northern Ohio Medical Specialists,LLCGroup PAC ID 2769386192, 252 clinicians

Practice addresses (Care Compare)

3004 Hayes Ave
Sandusky, OH 44870-5321
Phone (419) 609-1112

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C.0900588OHMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Wellqor Psychological Services, PC CurrentSince Sep 25, 2025 Accepting new patients
Bayshore Counseling Services, Inc. CurrentSince Jan 3, 2024 Accepting new patients
Bayshore Counseling Services, Inc. PastSince Jan 3, 2024 Accepting new patients

Locations

135 Pinelawn Rd
Ste 204N
Melville, NY 11747
Phone (631) 328-2440

1900 Polaris Pkwy
Ste 450
Columbus, OH 43240
Phone (614) 423-9352

5232 Broadview Rd
Richfield, OH 44286
Phone (330) 623-6680

1634 Sycamore Line
Sandusky, OH 44870
Phone (419) 626-9156

Organizations & group practices 4

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": "1349654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349654400000",
    "number": "1134471642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1218 CLEVELAND RD",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448704200",
            "telephone_number": "419-626-9156",
            "fax_number": "419-621-0099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1218 CLEVELAND RD",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448704200",
            "telephone_number": "419-626-9156",
            "fax_number": "419-621-0099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "TAMMY",
        "middle_name": "S",
        "name_prefix": "Ms.",
        "credential": "PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-08",
        "last_updated": "2012-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "C.0900588",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2325906",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandusky, OH

Sources for this page

Verify at the official NPI Registry.