Ilisa Henderson, MSW LCSWA

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P014518 Issued in NC

Practice address

714 S Main St
Salisbury, NC 28144-5412

Phone

(866) 495-3651

NPI assigned

Sep 24, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• S&H Youth and Adult Services, Inc.

  • Community/Behavioral Health Agency
  • Salisbury, NC
  • NPI 1013117720
  NPD

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

{
    "created_epoch": "1600905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600905600000",
    "number": "1356958334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10111 PINTAIL PL APT 105",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282691912",
            "telephone_number": "609-472-9864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 S MAIN ST",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281445412",
            "telephone_number": "866-495-3651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "ILISA",
        "name_prefix": "Mrs.",
        "credential": "MSW LCSWA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-24",
        "last_updated": "2020-09-24",
        "certification_date": "2020-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P014518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Rush Hedrick, M.S.
• Jennifer Hedrick
• Melvin Deryl Heilig, PA-C
• Lynda Michelle Heintz, FNP
• James Helms, CRNA
• Kimberly Henderson, RPH
• Alexis Branch Henley, DPT
• Mary Fisher Henley, FNP-C
• Timothy James Hennie, O.D.
• Michelle Buie Henrickson, RD

• Clinical Social Worker in Salisbury, NC
• Providers in Salisbury, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2020; 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.