Individual provider Active NPI

Dora Lynn Henderson, LMHC

  • Mental Health Counselor
  • Longwood, FL
National Provider Identifier
1346665296
Registry record updated Sep 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH 12311 Issued in FL
Practice address
1250 S US Highway 17 92 Ste 150
Longwood, FL 32750-5712
Phone
(407) 863-2121
NPI assigned
Mar 2, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH 12311 FL Primary

Addresses

Primary practice location

1250 S US Highway 17 92 Ste 150
Longwood, FL 32750-5712

Mailing address

142 Circle Hill Rd
Sanford, FL 32773-4770
Phone (407) 863-2121

Other names 1

  • Dora Lynn Dash Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240812003061 FL Practitioner - Mental Health Counselor 7810435641

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MH 12311FLMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1393718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725580800000",
    "number": "1346665296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 CIRCLE HILL RD",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327734770",
            "telephone_number": "407-863-2121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 S US HIGHWAY 17 92 STE 150",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327505712",
            "telephone_number": "407-863-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "DORA",
        "middle_name": "LYNN",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-02",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH 12311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DORA",
            "last_name": "DASH",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Longwood, FL

Sources for this page

Verify at the official NPI Registry.