Active NPI
Henry Isaac
- Mental Health Counselor
- Memphis, TN
National Provider Identifier
1295206514
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 04250
- Practice address
- 560 Colonial Rd Ste 201
Memphis, TN 38117-4097 - Phone
- (901) 930-7397
- Fax
- (901) 244-6528
- NPI assigned
- Dec 14, 2018
- Last updated
- Dec 14, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 04250 | TN | Primary |
Addresses
Primary practice location
560 Colonial Rd Ste 201
Memphis, TN 38117-4097
Mailing address
560 Colonial Rd Ste 201
Memphis, TN 38117-4097
Phone (901) 930-7397
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 1998
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
35 S Auburndale St
Memphis, TN 38104-3916
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 04250 | TN | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Forward Counseling, PLC | Mental Health | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1544745600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1544745600000",
"number": "1295206514",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "560 COLONIAL RD STE 201",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381174097",
"telephone_number": "901-930-7397",
"fax_number": "901-244-6528"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "560 COLONIAL RD STE 201",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381174097",
"telephone_number": "901-930-7397",
"fax_number": "901-244-6528"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ISAAC",
"first_name": "HENRY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-12-14",
"last_updated": "2018-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "TN",
"license": "04250",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Memphis, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.