Individual provider Active NPI

Misty Cox Henderson

  • Clinical Social Worker
  • Christiansburg, VA
National Provider Identifier
1225659113
Registry record updated May 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904005134 Issued in VA
Practice address
602 Radford St
Christiansburg, VA 24073-3303
Phone
(540) 230-8589
NPI assigned
May 1, 2020
Last updated
May 1, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0904005134 VA Primary

Addresses

Primary practice location

602 Radford St
Christiansburg, VA 24073-3303

Mailing address

1010 Custis St
Radford, VA 24141-2718

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20200817003527 VA Practitioner - Clinical Social Worker 1850717117 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Virginia Commonwealth University, School of Medicine, 1995
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

6580 Valley Ctr Dr
Suite 321
Fairlawn, VA 24141-5696
Phone (546) 230-8589

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904005134VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Misty Cox Henderson, LCSW, LLC Clinical CurrentSince Jun 10, 2020 Accepting new patients
Stephanie Whited, LCSW LLC Clinical PastSince May 17, 2020 Accepting new patients

Locations

602 Radford St
Christiansburg, VA 24073
Phone (540) 230-8589

6580 Valley Center Dr
Ste 321
Radford, VA 24141
Phone (546) 230-8589

Organizations & group practices 2

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": "1588291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588291200000",
    "number": "1225659113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 CUSTIS ST",
            "city": "RADFORD",
            "state": "VA",
            "postal_code": "241412718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 RADFORD ST",
            "city": "CHRISTIANSBURG",
            "state": "VA",
            "postal_code": "240733303",
            "telephone_number": "540-230-8589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COX HENDERSON",
        "first_name": "MISTY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-01",
        "last_updated": "2020-05-01",
        "certification_date": "2020-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904005134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Christiansburg, VA

Sources for this page

Verify at the official NPI Registry.