Matthew Morgan Henderson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

20050 Issued in TX

Practice address

4220 Duncan Ave Ste 201
Saint Louis, MO 63110-1103

Phone

(210) 274-6609

NPI assigned

Jan 13, 2007

Sex

Male

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Matthew Morgan Henderson Counseling LLC

  • Clinical Social Worker
  • Saint Louis, MO
  • NPI 1144087792
  NPD Authorized official

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

{
    "created_epoch": "1168646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702339200000",
    "number": "1235280744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4912 PERSHING PL",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631081202",
            "telephone_number": "210-274-6609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4220 DUNCAN AVE STE 201",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101103",
            "telephone_number": "210-274-6609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "MATTHEW",
        "middle_name": "MORGAN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-13",
        "last_updated": "2023-12-12",
        "certification_date": "2023-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "20050",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1535569-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Henderson, RN
• Jeffrey Parker Henderson, MD
• Katherine E Henderson, MD
• Kathryn R Henderson, M.D.
• Kristina L Henderson, M.D.
• Miquia Sherree Henderson, MD
• Nashika Henderson, LPN
• Poppy Henderson
• Ricardia Angelica Henderson, MSW LCSW
• Sarah Jane Henderson, R.N.

• Clinical Social Worker in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2023; 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.