NPIMap

Organization Active NPI

Henderson Behavioral Health, Inc.

  • Clinical Social Worker
  • Fort Lauderdale, FL
National Provider Identifier
1497337570
Registry record updated Apr 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
HENDERSON BEHAVIORAL HEALTH, INC.
Practice address
330 SW 27TH Ave
Ft Lauderdale, FL 33312-2051
Phone
(954) 497-3856
Fax
(954) 497-2901
NPI assigned
Apr 27, 2021
Last updated
Apr 27, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
HENDERSON BEHAVIORAL HEALTH, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 27, 2021

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

Authorized official

Name
Carol Loman
Title
Billing Supervisor
Phone
(954) 497-3856

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary
Community/Behavioral Health Agency 251S00000X

Addresses

Primary practice location

330 SW 27TH Ave
Ft Lauderdale, FL 33312-2051

Mailing address

4740 N State Road 7 Ste 201
Lauderdale Lakes, FL 33319-5839
Phone (954) 881-2386

Other identifiers 1

IdentifierTypeStateIssuer
060338400MedicaidFL

Other names 1

  • Central OP Location Other name

National Provider Directory

National Provider Directory
Tax ID family
Henderson Behavioral Health10 organizations share this tax ID, including this one
Part of
Henderson Behavioral Health

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1619481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619481600000",
    "number": "1497337570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4740 N STATE ROAD 7 STE 201",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333195839",
            "telephone_number": "954-881-2386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 SW 27TH AVE",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333122051",
            "telephone_number": "954-497-3856",
            "fax_number": "954-497-2901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENDERSON BEHAVIORAL HEALTH, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HENDERSON BEHAVIORAL HEALTH, INC.",
        "enumeration_date": "2021-04-27",
        "last_updated": "2021-04-27",
        "certification_date": "2021-04-27",
        "status": "A",
        "authorized_official_last_name": "LOMAN",
        "authorized_official_first_name": "CAROL",
        "authorized_official_title_or_position": "BILLING SUPERVISOR",
        "authorized_official_telephone_number": "954-497-3856"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "060338400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Central OP Location",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2021; 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.