Jimmy Daniel Henry, MSW, LCSW-S

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

30555 Issued in TX

Practice address

6029 Carriage Cpe
San Antonio, TX 78261-2242

Phone

(210) 268-6125

Fax

(419) 745-8425

NPI assigned

Oct 21, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

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.

• Sondermind Provider Network LLC

  • Clinical Social Worker
  • Denver, CO
  • NPI 1760854442

  TX

  Medicare reassignment NPD

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

{
    "created_epoch": "1129852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1467442434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18235 BULVERDE RD",
            "address_2": "SUITE 105, #36",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78259",
            "telephone_number": "210-268-6125",
            "fax_number": "419-745-8425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6029 CARRIAGE CPE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782612242",
            "telephone_number": "210-268-6125",
            "fax_number": "419-745-8425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "JIMMY",
        "middle_name": "DANIEL",
        "name_prefix": "Mr.",
        "credential": "MSW, LCSW-S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-21",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "30555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandon Michael Henry
• Dana Henry
• James Henry, MD
• Janet Henry
• Jennive Andrea Henry, MS, NCC, LPC, CST
• Judith M Henry, OTR
• Kelsey Henry
• Kyree Henry, PHARM.D.
• Lauren Justine Henry, PHARMD
• Michael Alan Henry, DDS, PHD

• Clinical Social Worker in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.