Jeff Henderson, PHD

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

4041 Issued in AZ

Practice address

1680 W Iron Springs Rd
Suite 102
Prescott, AZ 86305-3313

Phone

(928) 458-6634

Fax

(928) 445-2919

NPI assigned

Sep 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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

Specialty

Clinical Psychologist

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Jeff Henderson PHD Psychological Services and Consulting PC

  • Counseling Psychologist
  • Prescott, AZ
  • NPI 1255413118
  Medicare reassignment NPD

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576368000000",
    "number": "1508964784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11464",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863041464",
            "telephone_number": "928-458-6634",
            "fax_number": "928-541-1422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1680 W IRON SPRINGS RD",
            "address_2": "SUITE 102",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863053313",
            "telephone_number": "928-458-6634",
            "fax_number": "928-445-2919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "JEFF",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2019-12-15",
        "certification_date": "2019-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "UT",
            "license": "5653842-2501",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "AZ",
            "license": "4041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gary Hees, LPC
• Herman Charles Heikkenen, MD
• Thomas Jeffrey Hein, LPC
• Arthur Lynn Heitzman, PH.D.
• Helen Paslay Professional Nurse Practitioner Services PLLC
• Gregory Hendrickson, PHARM.D.
• Jannas Ashlee Hennington, APN
• Martha L Henshaw, P.T.
• Sharon Henshaw, RN
• Matthew Jay Hepworth

• Counseling Psychologist in Prescott, AZ
• Providers in Prescott, AZ by specialty
• Counseling Psychologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.