Active NPI
Jill P Henderson, LPC
- Mental Health Counselor
- Richardson, TX
National Provider Identifier
1366690331
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 62563
- Practice address
- 2099 N Collins Blvd Ste 100
Richardson, TX 75080-2699 - Phone
- (972) 437-4698
- Fax
- (972) 690-9309
- NPI assigned
- Sep 3, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 62563 | TX | Primary |
Addresses
Primary practice location
2099 N Collins Blvd Ste 100
Richardson, TX 75080-2699
Mailing address
2099 N Collins Blvd Ste 100
Richardson, TX 75080-2699
Phone (972) 437-4698
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 62563 | TX | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1220400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1220400000000",
"number": "1366690331",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2099 N COLLINS BLVD STE 100",
"city": "RICHARDSON",
"state": "TX",
"postal_code": "750802699",
"telephone_number": "972-437-4698",
"fax_number": "972-690-9309"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2099 N COLLINS BLVD STE 100",
"city": "RICHARDSON",
"state": "TX",
"postal_code": "750802699",
"telephone_number": "972-437-4698",
"fax_number": "972-690-9309"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDERSON",
"first_name": "JILL",
"middle_name": "P",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-09-03",
"last_updated": "2008-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "TX",
"license": "62563",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Richardson, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.