Individual provider Active NPI

Roberto Armando Henderson, M.S.,CAADAC,NAMA

  • Addiction (Substance Use Disorder) Counselor
  • Long Beach, CA
National Provider Identifier
1477893774
Registry record updated May 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
A07490315 Issued in CA
Practice address
2653 Ostrom Ave
Long Beach, CA 90815-1602
Phone
(949) 201-3592
NPI assigned
Feb 22, 2013
Last updated
May 14, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X A07490315 CA Primary

Addresses

Primary practice location

2653 Ostrom Ave
Long Beach, CA 90815-1602

Mailing address

2653 Ostrom Ave
Long Beach, CA 90815-1602
Phone (949) 201-3592

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
A07490315CAMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1361491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778716800000",
    "number": "1477893774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2653 OSTROM AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908151602",
            "telephone_number": "949-201-3592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2653 OSTROM AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908151602",
            "telephone_number": "949-201-3592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "ROBERTO",
        "middle_name": "ARMANDO",
        "name_prefix": "Mr.",
        "credential": "M.S.,CAADAC,NAMA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-02-22",
        "last_updated": "2026-05-14",
        "certification_date": "2026-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "A07490315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2026; 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.