Tracy Ann Henderson, MA, BHT

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

3222 N 37TH St
Phoenix, AZ 85018-6304

Phone

(602) 599-5475

Fax

(602) 522-8338

NPI assigned

Nov 10, 2014

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

Credentials

Master of Arts

Practice roles

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.

• Lifewell Behavioral Wellness

  • Mental Illness Community Based Residential Treatment Facility
  • Phoenix, AZ
  • NPI 1154401156
  NPD (past)

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

{
    "created_epoch": "1415577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415577600000",
    "number": "1235535873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 E EARLL DR",
            "address_2": "SUITE 200",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122647",
            "telephone_number": "602-599-5404",
            "fax_number": "602-599-5704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3222 N 37TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850186304",
            "telephone_number": "602-599-5475",
            "fax_number": "602-522-8338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "TRACY",
        "middle_name": "ANN",
        "credential": "MA, BHT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-10",
        "last_updated": "2014-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marlena Henderson, LPC
• Mary A. Henderson, LM
• Michael Henderson
• Sarah Elizabeth Henderson, LCSW
• Tarann Henderson, M.D.
• Barry A Hendin, MD
• Holly Hendin, M.D., PH.D.
• Melanie Rose Hendren
• Patricia Selina Hendrick, COTA
• Carlee Hendricks, MD

• All providers in Phoenix, AZ
• Case Manager/Care Coordinator in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2014; 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.