Brittany Diane Henderson, LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

4255 Pheasant Ridge Dr NE Ste 412
Blaine, MN 55449-5066

Phone

(763) 703-3754

NPI assigned

May 3, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Citrine Psychological Services LTD

  • Mental Health Counselor
  • Woodbury, MN
  • NPI 1932973930
  NPD Authorized official

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

{
    "created_epoch": "1556841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660867200000",
    "number": "1346805488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "665 KINGFISHER LN APT C",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551251843",
            "telephone_number": "651-703-1681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4255 PHEASANT RIDGE DR NE STE 412",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554495066",
            "telephone_number": "763-703-3754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "BRITTANY",
        "middle_name": "DIANE",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-03",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Healthy Living Homecare
• Lynn Heidemann, LICSW
• Niklas Fuqiang Heine, DDS
• Judy Marie Helgeson
• Brian J Helmrick, ATC
• Tamara Joy Hendrickson, ABO, NCLE
• Noah Mitchell Henrichsen
• Armanti Lamone Henry
• Michelle Nicole Herr, PHARMD
• Anastasia G Herrera

• Mental Health Counselor in Blaine, MN
• Providers in Blaine, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2022; 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.