Individual provider Active NPI

Tressa Henson, LPC

  • Professional Counselor
  • Southgate, MI
National Provider Identifier
1255770004
Registry record updated Sep 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6401013444 Issued in MI
Practice address
14799 Dix Toledo Rd
Southgate, MI 48195-2507
Phone
(734) 324-8326
NPI assigned
Jun 14, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 6401013444 MI Primary
Counselor 101Y00000X 6401013444 MI
Professional Counselor 101YP2500X

Addresses

Primary practice location

14799 Dix Toledo Rd
Southgate, MI 48195-2507

Mailing address

14799 Dix Toledo Rd
Southgate, MI 48195-2507
Phone (734) 324-8326

Other practice location 1

30500 Van Dyke Ave
Warren, MI 48093-2195
Phone (586) 558-6868

Other practice location 2

PO Box 256
Kotzebue, AK 99752-0256
Phone (907) 424-7031

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20240502001912 MI Practitioner - Mental Health Counselor 5799019519 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Shine Medical Providers PC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.tressahenson@150339.advancedmd-direct.com

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": "1371168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757980800000",
    "number": "1255770004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14799 DIX TOLEDO RD",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481952507",
            "telephone_number": "734-324-8326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14799 DIX TOLEDO RD",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481952507",
            "telephone_number": "734-324-8326"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30500 Van Dyke Ave",
            "address_purpose": "LOCATION",
            "city": "Warren",
            "state": "MI",
            "postal_code": "480932195",
            "country_code": "US",
            "telephone_number": "586-558-6868",
            "fax_number": "586-558-6893",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "PO Box 256",
            "address_purpose": "LOCATION",
            "city": "Kotzebue",
            "state": "AK",
            "postal_code": "997520256",
            "country_code": "US",
            "telephone_number": "907-424-7031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENSON",
        "first_name": "TRESSA",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-14",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401013444",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6401013444",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southgate, MI

Sources for this page

Verify at the official NPI Registry.