Winifred C Henken, PHD, QMHP

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

1975 McPherson St
Suite 2
North Bend, OR 97459-3482

Phone

(541) 756-2020

Fax

(541) 756-8982

NPI assigned

Jan 14, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Winifred C Elliott Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1231891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231891200000",
    "number": "1255578159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1975 MCPHERSON ST",
            "address_2": "SUITE 2",
            "city": "NORTH BEND",
            "state": "OR",
            "postal_code": "974593482",
            "telephone_number": "541-756-2020",
            "fax_number": "541-756-8982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1975 MCPHERSON ST",
            "address_2": "SUITE 2",
            "city": "NORTH BEND",
            "state": "OR",
            "postal_code": "974593482",
            "telephone_number": "541-756-2020",
            "fax_number": "541-756-8982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENKEN",
        "first_name": "WINIFRED",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "PHD, QMHP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-14",
        "last_updated": "2009-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY11720",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WINIFRED",
            "last_name": "ELLIOTT",
            "middle_name": "C",
            "prefix": "DR.",
            "credential": "PHD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Case Manager/Care Coordinator in North Bend, OR
• Providers in North Bend, OR by specialty
• Case Manager/Care Coordinator in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2009; 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.