Robert R Henderson

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY11285 Issued in FL

Practice address

8491 NW 39TH Ave
Gainesville, FL 32606-5635

Phone

(352) 265-4357

NPI assigned

Mar 28, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

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

Specialty

Clinical Psychologist

Education

Other, 2018

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Florida Clinical Practice Association Inc

  • Surgery Physician
  • Gainesville, FL
  • NPI 1063463768
  Medicare reassignment
• Anxiety Specialists of Atlanta LLC

  • Community/Behavioral Health Agency
  • Dunwoody, GA
  • NPI 1083291512

  Clinical

  NPD

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

{
    "created_epoch": "1490659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778457600000",
    "number": "1346772589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100256",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326100256",
            "telephone_number": "352-294-4900",
            "fax_number": "352-294-9887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8491 NW 39TH AVE",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326065635",
            "telephone_number": "352-265-4357"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 SW Archer Rd",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326103003",
            "country_code": "US",
            "telephone_number": "352-265-0111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 Crittenden Blvd",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146428409",
            "country_code": "US",
            "telephone_number": "585-275-3563",
            "fax_number": "585-276-2292",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1360 Center Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Dunwoody",
            "state": "GA",
            "postal_code": "303384135",
            "country_code": "US",
            "telephone_number": "678-825-2320",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "ROBERT",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-28",
        "last_updated": "2026-05-11",
        "certification_date": "2026-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY004688",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY11285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Henderson
• Jamira S Henderson
• Joseph Smith Henderson, LMT
• Kerry Henderson, MD
• Lalitha Pauliah Henderson, AUD
• Valerie Lopez Henderson, PHARM.D.
• Viktoria B Henderson
• Deja Hendricks
• Nicholas McCulloch Hendricks
• Seth Hendricks

• Clinical Psychologist in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2026; 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.

Verify at the official NPI Registry.