Individual provider Active NPI

Heather B Henry, LICSW

  • Clinical Social Worker
  • Fort Payne, AL
National Provider Identifier
1225794803
Registry record updated May 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
4902C Issued in AL
Practice address
1951 Gault Ave N
Fort Payne, AL 35967-3417
Phone
(256) 273-6800
NPI assigned
Nov 9, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2023

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 4902C AL Primary

Addresses

Primary practice location

1951 Gault Ave N
Fort Payne, AL 35967-3417

Mailing address

1951 Gault Ave N
Fort Payne, AL 35967-3417
Phone (256) 273-6800

Other practice location 1

772 McCurdy Ave S
Rainsville, AL 35986-5211
Phone (256) 638-3776

Other identifiers 1

IdentifierTypeStateIssuer
4902COtherALSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20220916001396 AL Practitioner - Clinical Social Worker 3274918966 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1951 Gault Ave N
Fort Payne, AL 35967-3417
Phone (256) 273-6800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mind Right, LLC Clinical CurrentSince Aug 3, 2022 Accepting new patients
Dove Renew CurrentSince Nov 1, 2021 Accepting new patients

Locations

1951 Gault Ave N
Fort Payne, AL 35967
Phone (256) 273-6800

1949 Gault Ave N
Ste 104
Fort Payne, AL 35967
Phone (256) 330-7008

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1636416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683158400000",
    "number": "1225794803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1951 GAULT AVE N",
            "city": "FORT PAYNE",
            "state": "AL",
            "postal_code": "359673417",
            "telephone_number": "256-273-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1951 GAULT AVE N",
            "city": "FORT PAYNE",
            "state": "AL",
            "postal_code": "359673417",
            "telephone_number": "256-273-6800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "772 McCurdy Ave S",
            "address_purpose": "LOCATION",
            "city": "Rainsville",
            "state": "AL",
            "postal_code": "359865211",
            "country_code": "US",
            "telephone_number": "256-638-3776",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENRY",
        "first_name": "HEATHER",
        "middle_name": "B",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-09",
        "last_updated": "2023-05-04",
        "certification_date": "2023-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AL",
            "license": "4902C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "4902C",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Payne, AL

Sources for this page

Verify at the official NPI Registry.