Active NPI
Carolyn J. Henderson, L.I.C.S.W.
- Clinical Social Worker
- New Town, ND
National Provider Identifier
1316015647
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 3253
- Practice address
- 1 Minni Tohe Dr
Minne Tohe Health Center
New Town, ND 58763-4400 - Phone
- (701) 627-4701
- Fax
- (701) 627-2810
- NPI assigned
- Dec 4, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 3253 | ND | Primary |
Addresses
Primary practice location
1 Minni Tohe Dr
Minne Tohe Health Center
New Town, ND 58763-4400
Mailing address
1 Minni Tohe Dr
Minne Tohe Health Center
New Town, ND 58763-4400
Phone (701) 627-4701
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3253 | ND | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Elbowoods Memorial Health Center | 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 and National Provider Directory roles.
-
- Clinic/Center
- New Town, ND
- NPI 1831365519
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1316015647",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 MINNI TOHE DR",
"address_2": "MINNE TOHE HEALTH CENTER",
"city": "NEW TOWN",
"state": "ND",
"postal_code": "587634400",
"telephone_number": "701-627-4701",
"fax_number": "701-627-2810"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 MINNI TOHE DR",
"address_2": "MINNE TOHE HEALTH CENTER",
"city": "NEW TOWN",
"state": "ND",
"postal_code": "587634400",
"telephone_number": "701-627-4701",
"fax_number": "701-627-2810"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDERSON",
"first_name": "CAROLYN",
"middle_name": "J.",
"name_prefix": "Ms.",
"credential": "L.I.C.S.W.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "ND",
"license": "3253",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Town, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.