Sandra Hendricks, MSSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

3456 Issued in WI

Practice address

1102 S Park St
Suite 400
Madison, WI 53715-1708

Phone

(608) 282-8270

Fax

(608) 287-5992

NPI assigned

Jan 7, 2016

Sex

Female

Sole proprietor

No

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

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Lake City Counseling, LLCGroup PAC ID 6103995477, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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.

• Lake City Counseling, LLC

  • Counselor
  • Monona, WI
  • NPI 1679755987
  Medicare reassignment Care Compare group NPD
• University of Wisconsin Medical Foundation Inc

  • Durable Medical Equipment & Medical Supplies
  • Cross Plains, WI
  • NPI 1174583363
  NPD (past)
• University of Wisconsin System Non Payroll

  dba UW Health

  • Multi-Specialty Clinic/Center
  • Madison, WI
  • NPI 1346266319
  NPD (past)

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

{
    "created_epoch": "1452124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462492800000",
    "number": "1437515327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2802 SOMMERS AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537045719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 S PARK ST",
            "address_2": "SUITE 400",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151708",
            "telephone_number": "608-282-8270",
            "fax_number": "608-287-5992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRICKS",
        "first_name": "SANDRA",
        "credential": "MSSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-07",
        "last_updated": "2016-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "1111",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "3456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donnie Henderson, CST
• Nancy K Henderson, LCSW
• Paul Lars Henderson, PA-C
• Sheryl L Henderson, MD
• Andrew Hendrick
• Dan R Hendrickson
• Elizabeth Hendrickson, CAPSW
• Jennifer Kay Hendrickson, RN
• Marie Anne-Elizabeth Hendrickson, M.S., CCC-SLP
• Natalia B Hendrickson, PA-C

• Clinical Social Worker in Madison, WI
• Providers in Madison, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.