Individual provider Active NPI

Aubreyanna M Henshaw, QMHA; CADC-R

  • Social Worker
  • Baker City, OR
National Provider Identifier
1417499013
Registry record updated Sep 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
3425 13TH St
Baker City, OR 97814-1340
Phone
(541) 523-7400
Fax
(541) 523-4927
NPI assigned
Nov 14, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X T-19-369- OR
Behavior TechnicianGroup: 193200000X MULTI-SPECIALTY GROUP 106S00000X 19-QMHA-I-02569 OR
Social Worker 104100000X Primary

Addresses

Primary practice location

3425 13TH St
Baker City, OR 97814-1340

Mailing address

3425 13TH St
Baker City, OR 97814-1340
Phone (541) 523-7400

Other names 1

  • Ms. Aubreyanna M McCutchen Former name

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

LicenseStateTypeSpecialty
T-19-369-ORMDAddiction (Substance Use Disorder) Counselor
19-QMHA-I-02569ORMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
New Directions Northwest, Inc Multi-Specialty CurrentSince Nov 16, 2020 Accepting new patients

Locations

2200 4th St
Baker City, OR 97814
Phone (541) 523-3646

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1479081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599696000000",
    "number": "1417499013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3425 13TH ST",
            "city": "BAKER CITY",
            "state": "OR",
            "postal_code": "978141340",
            "telephone_number": "541-523-7400",
            "fax_number": "541-523-4927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3425 13TH ST",
            "city": "BAKER CITY",
            "state": "OR",
            "postal_code": "978141340",
            "telephone_number": "541-523-7400",
            "fax_number": "541-523-4927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENSHAW",
        "first_name": "AUBREYANNA",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "QMHA; CADC-R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-14",
        "last_updated": "2020-09-10",
        "certification_date": "2020-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "T-19-369-",
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Technician",
            "state": "OR",
            "license": "19-QMHA-I-02569",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AUBREYANNA",
            "last_name": "MCCUTCHEN",
            "middle_name": "M",
            "prefix": "MS.",
            "credential": "QMHA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Baker City, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 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.