The Shaping: Therapeutic & Wellness Services

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

THE SHAPING: THERAPEUTIC & WELLNESS SERVICES

Doing business as

The Shaping: Therapeutic & Wellness Services

Practice address

2324 Mill Ridge Dr
Montgomery, AL 36117-4780

Phone

(334) 419-4605

NPI assigned

Aug 1, 2024

Organization subpart

No

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

Authorized official

Name

Angelene Clarissa Kendall-HendersonNPI 1508604794

Title

Owner

Phone

(334) 419-4605

Specialties & licenses 2

Addresses

Other names 1

• The Shaping: Therapeutic & Wellness Services Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Angelene Clarissa Kendall-Henderson, LPC

  • Clinical Psychologist
  • Montgomery, AL
  • NPI 1508604794
  NPD Authorized official

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

{
    "created_epoch": "1722470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733702400000",
    "number": "1285463620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2324 MILL RIDGE DR",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361174780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2324 MILL RIDGE DR",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361174780",
            "telephone_number": "334-419-4605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE SHAPING: THERAPEUTIC & WELLNESS SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-01",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A",
        "authorized_official_last_name": "KENDALL-HENDERSON",
        "authorized_official_first_name": "ANGELENE",
        "authorized_official_middle_name": "CLARISSA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "334-419-4605"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Shaping: Therapeutic & Wellness Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Shaping: Therapeutic & Wellness Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinical Psychologist in Montgomery, AL
• Providers in Montgomery, AL by specialty
• Clinical Psychologist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2024; 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.