Active NPI
Gregory Henderson
- Professional Counselor
- Greensboro, NC
National Provider Identifier
1417206251
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 9852
- Practice address
- 200 E Bessemer Ave
Greensboro, NC 27401-1416 - Phone
- (336) 437-4462
- Fax
- (336) 217-8340
- NPI assigned
- Sep 7, 2012
- Last updated
- Oct 19, 2021
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 9852 | NC | Primary |
Addresses
Primary practice location
200 E Bessemer Ave
Greensboro, NC 27401-1416
Mailing address
284 Executive Park Dr Ste 100
Concord, NC 28025-1833
Phone (704) 939-1100
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 |
|---|---|---|---|
| 9852 | NC | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Daymark Recovery Servcies Inc | Professional | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Community/Behavioral Health Agency
- Winston Salem, NC
- NPI 1790807535
Professional
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1346976000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1634601600000",
"number": "1417206251",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "284 EXECUTIVE PARK DR STE 100",
"city": "CONCORD",
"state": "NC",
"postal_code": "280251833",
"telephone_number": "704-939-1100",
"fax_number": "704-939-1173"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 E BESSEMER AVE",
"city": "GREENSBORO",
"state": "NC",
"postal_code": "274011416",
"telephone_number": "336-437-4462",
"fax_number": "336-217-8340"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDERSON",
"first_name": "GREGORY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-09-07",
"last_updated": "2021-10-19",
"certification_date": "2021-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "9852",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greensboro, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.