Jeff Henderson PHD Psychological Services and Consulting PC

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

4041 Issued in AZ

Legal business name

JEFF HENDERSON PHD PSYCHOLOGICAL SERVICES AND CONSULTING PC

Practice address

1680 W Iron Springs Rd
Suite 102
Prescott, AZ 86305-3313

Phone

(928) 458-6634

Fax

(928) 445-2919

NPI assigned

Oct 19, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Jeffery Paul Henderson, PHD

Title

President Psychologist

Phone

(928) 458-6634

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeff Henderson, PHD

  • Counseling Psychologist
  • Prescott, AZ
  • NPI 1508964784
  Medicare reassignment NPD
• Adam John Vellturo, MSW

  • Clinical Social Worker
  • Prescott, AZ
  • NPI 1760571269
  NPD (past)
• Steven L. Ater, PSY.D.

  • Clinical Neuropsychologist
  • Pocatello, ID
  • NPI 1902906209
  NPD (past)
• Michael J Bjornson, PH.D.

  • Clinical Psychologist
  • Cheyenne, WY
  • NPI 1558411025
  NPD (past)
• Dan Bernard Goodkind, PH.D.

  • Clinical Psychologist
  • Vernal, UT
  • NPI 1053418053
  NPD (past)
• Carolyn S. Henry, LCSW

  • Clinical Social Worker
  • Vernal, UT
  • NPI 1194814475
  NPD (past)

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252972800000",
    "number": "1255413118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7929 E SLEEPY OWL WAY",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863153023",
            "telephone_number": "928-458-6634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1680 W IRON SPRINGS RD",
            "address_2": "SUITE 102",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863053313",
            "telephone_number": "928-458-6634",
            "fax_number": "928-445-2919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFF HENDERSON PHD PSYCHOLOGICAL SERVICES AND CONSULTING PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-19",
        "last_updated": "2009-09-15",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "JEFFERY",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "PRESIDENT PSYCHOLOGIST",
        "authorized_official_telephone_number": "928-458-6634",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Counseling",
            "state": "AZ",
            "license": "4041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olamide D Jarrett, M.D.
• Jamie Jarvis, PA-C
• Jason C. Campbell DDS.
• Francisco Jaume, D.O.
• Derek Jeanes
• Renee A Jelinek, M.D.
• Jacqueline Jendrisak
• Roger Cain Jenkins Jr., MD
• Karen E Jensen, LCSW, CCM
• Richard C. Jirsa, DDS

• Counseling Psychologist in Prescott, AZ
• Providers in Prescott, AZ by specialty
• Counseling Psychologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.