Shenise Nicole Henderson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW019233 Issued in PA

Practice address

8122 Forrest Ave
Philadelphia, PA 19150-2402

Phone

(267) 471-9849

NPI assigned

Mar 16, 2016

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1458086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475452800000",
    "number": "1194186353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8122 FORREST AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191502402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8122 FORREST AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191502402",
            "telephone_number": "267-471-9849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "SHENISE",
        "middle_name": "NICOLE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-16",
        "last_updated": "2016-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW019233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen Henderson, MSN, CRNP
• Melissa Ann Henderson, RN
• Michaela Henderson, MD
• Paul L Henderson, BS
• Shelley Joyceanne Thomas Henderson, MD
• Shonquell S Henderson
• Barry Hendler, MD DDS
• Jillian Hendricks, M.A. CCC-SLP
• Summer Hendricks
• Hendrix Pharmacy Inc

• Clinical Social Worker in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 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.

Verify at the official NPI Registry.