Jaime Lynn Henderson, LPCC, LMHC, LCPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

4601 Daywalt Rd
Sebastopol, CA 95472-6016

Phone

(413) 561-5675

NPI assigned

Nov 5, 2010

Sex

Female

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 MA, CA2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jaimehenderson@tdh.allscriptsdirect.net

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.

• Grow Healthcare Group PC

  • Mental Health Counselor
  • San Jose, CA
  • NPI 1154994846
  Medicare reassignment NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  MA

  Medicare reassignment NPD
• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567

  Mental Health

  NPD

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

{
    "created_epoch": "1288915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698364800000",
    "number": "1497056568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2780",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954732780",
            "telephone_number": "413-561-5675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 DAYWALT RD",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954726016",
            "telephone_number": "413-561-5675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "JAIME",
        "middle_name": "LYNN",
        "name_prefix": "Miss",
        "credential": "LPCC, LMHC, LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-05",
        "last_updated": "2023-10-27",
        "certification_date": "2023-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robin Siobhan Hausserman, LCSW
• Laura Jean Havstad, PH.D.
• Healthspring Acupuncture Inc.
• Heart Folk Midwifery
• Taylor Marie Heissenbuttel
• Jeffrey Yates Hergenrather, MD
• Mira Herman, DC, LAC
• Richard Jay Hersh, M.D.
• Gary Ronald Herzberg, MD
• Cori Herzig, PSY.D.

• Mental Health Counselor in Sebastopol, CA
• Providers in Sebastopol, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 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.