Susan D Hendrickson, LCSW

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

954 Issued in CO

Practice address

4824 S Lemay Ave
Fort Collins, CO 80525-9402

Phone

(970) 482-1574

NPI assigned

Jan 8, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1199750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381968000000",
    "number": "1154506236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4860 ROBB ST",
            "address_2": "SUITE 201",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800332184",
            "telephone_number": "303-278-7418",
            "fax_number": "888-341-5050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4824 S LEMAY AVE",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805259402",
            "telephone_number": "970-482-1574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRICKSON",
        "first_name": "SUSAN",
        "middle_name": "D",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-08",
        "last_updated": "2013-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CO",
            "license": "954",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40258726",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "1199591",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROFESSIONAL LICENSE",
            "identifier": "CSW.00000954",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sandra Elizabeth Henderson, M.D.
• James D Hendrick, MD
• Jennifer M Hendrick, MD
• Debra Michelle Hendricks, LMT, C.N.A, AAS
• Jacqueline Suzanne Hendrickson
• Stephen Gerard Henke, M.D.
• Evelyn Henning
• Meaghan Hennings, LCSW
• Cassandra Lee Henry
• Craig Henry, B.O.C.O., B.O.C.PED

• Marriage & Family Therapist in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Marriage & Family Therapist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2013; 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.