Active NPI
Charles Todd Henderson, ED.S.
- Professional Counselor
- Greenville, AL
National Provider Identifier
1437564697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- C2252A
- Practice address
- 106 Stewart Ave
Greenville, AL 36037-1416 - Phone
- (334) 414-1408
- Fax
- (334) 382-7202
- NPI assigned
- Jun 26, 2014
- Sex
- Male
- Sole proprietor
- Yes
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 | C2252A | AL | Primary |
Addresses
Primary practice location
106 Stewart Ave
Greenville, AL 36037-1416
Mailing address
106 Stewart Ave
Greenville, AL 36037-1416
Phone (334) 414-1408
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 |
|---|---|---|---|
| C2252A | AL | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1403740800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1403740800000",
"number": "1437564697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "106 STEWART AVE",
"city": "GREENVILLE",
"state": "AL",
"postal_code": "360371416",
"telephone_number": "334-414-1408",
"fax_number": "334-382-7202"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "106 STEWART AVE",
"city": "GREENVILLE",
"state": "AL",
"postal_code": "360371416",
"telephone_number": "334-414-1408",
"fax_number": "334-382-7202"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDERSON",
"first_name": "CHARLES",
"middle_name": "TODD",
"name_prefix": "Mr.",
"credential": "ED.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-06-26",
"last_updated": "2014-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AL",
"license": "C2252A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenville, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.