Individual provider Active NPI

Nichole Henderson

  • Marriage & Family Therapist
  • Las Vegas, NV
National Provider Identifier
1275833592
Registry record updated Nov 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
4284 Issued in NV
Practice address
9402 W Lake Mead Blvd
Las Vegas, NV 89134-8312
Phone
(702) 530-3124
NPI assigned
Nov 2, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 16263 AZ
Marriage & Family Therapist 106H00000X 204989 TX
Marriage & Family Therapist 106H00000X 0717002070 VA
Marriage & Family Therapist 106H00000X 4284 NV Primary
Marriage & Family Therapist 106H00000X LF61524481 WA

Addresses

Primary practice location

9402 W Lake Mead Blvd
Las Vegas, NV 89134-8312

Mailing address

9402 W Lake Mead Blvd
Las Vegas, NV 89134-8312
Phone (702) 530-3124

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, AZ, WA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20250404002465 DC Practitioner - Marriage and Family Therapist 8022450840 Reassigns benefits to 1 organization
I20250630001060 AZ Practitioner - Marriage and Family Therapist 8022450840 Reassigns benefits to 1 organization
I20250630001709 WA Practitioner - Marriage and Family Therapist 8022450840 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16263AZMDMarriage & Family Therapist
204989TXMDMarriage & Family Therapist
0717002070VAMDMarriage & Family Therapist
LF61524481WAMDMarriage & Family Therapist

Networks

  • UT PPO

Organizations & group practices 1

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": "1288656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763424000000",
    "number": "1275833592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9402 W LAKE MEAD BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891348312",
            "telephone_number": "702-530-3124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9402 W LAKE MEAD BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891348312",
            "telephone_number": "702-530-3124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "NICHOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-02",
        "last_updated": "2025-11-18",
        "certification_date": "2025-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "AZ",
            "license": "16263",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "TX",
            "license": "204989",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "VA",
            "license": "0717002070",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NV",
            "license": "4284",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": "LF61524481",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.