Theresa M Henderson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW 2072 Issued in FL

Practice address

1210 Millennium Pkwy
Suite 1035
Brandon, FL 33511-4896

Phone

(813) 716-0585

Fax

(813) 814-0448

NPI assigned

Sep 26, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles (2 of 3)

Networks

• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: theresahenderson@tdh.allscriptsdirect.net

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.

• Theresa M Henderson, PA

  • Clinical Social Worker
  • Brandon, FL
  • NPI 1982979662
  NPD (past) Authorized official
• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567

  Clinical

  NPD

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326149014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9609 WOODBAY DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336262422",
            "telephone_number": "813-716-0585",
            "fax_number": "813-814-0448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 MILLENNIUM PKWY",
            "address_2": "SUITE 1035",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335114896",
            "telephone_number": "813-716-0585",
            "fax_number": "813-814-0448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "THERESA",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW 2072",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN HEALTH SERVICES",
            "identifier": "275650000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5650654",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUEOPTIONS",
            "identifier": "007822",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED BEHAVIORAL HEALTH",
            "identifier": "230056",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anfal Kathem Helu, MD
• Tiffany Hempill, CRNA
• Caleb Andrew Hendershott, PHARMD
• Gregory L Henderson Sr., M.D.
• Irish Henderson
• Jordon Hendrieth
• Henkin Neurosurgery P a
• Henkin Neurosurgery PA
• David Earl Henline, DC
• Tracy A Hennemann, PT

• Clinical Social Worker in Brandon, FL
• Providers in Brandon, FL by specialty
• Clinical Social Worker in Florida

• 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.

Verify at the official NPI Registry.