Individual provider Active NPI

Rebecca Henshaw, LCSW

  • Clinical Social Worker
  • Port Charlotte, FL
National Provider Identifier
1508540295
Registry record updated Jun 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW21438 Issued in FL
Practice address
1477 Stamford St
Port Charlotte, FL 33952-4747
Phone
(786) 972-5648
NPI assigned
Jun 13, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW21438 FL Primary

Addresses

Primary practice location

1477 Stamford St
Port Charlotte, FL 33952-4747

Mailing address

1477 Stamford St
Port Charlotte, FL 33952-4747
Phone (786) 972-5648

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

LicenseStateTypeSpecialty
SW21438FLMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1686614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686614400000",
    "number": "1508540295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1477 STAMFORD ST",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339524747",
            "telephone_number": "786-972-5648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1477 STAMFORD ST",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339524747",
            "telephone_number": "786-972-5648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENSHAW",
        "first_name": "REBECCA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-13",
        "last_updated": "2023-06-13",
        "certification_date": "2023-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW21438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2023; 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.