Active NPI
Julia Mae Henderson, MA, LPC, BC-TMH
- Professional Counselor
- Southaven, MS
National Provider Identifier
1568147346
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 3000
- Practice address
- 5740 Getwell Rd Ste D
Southaven, MS 38672-6346 - Phone
- (601) 790-0583
- NPI assigned
- Jun 19, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 3000 | MS | Primary |
Addresses
Primary practice location
5740 Getwell Rd Ste D
Southaven, MS 38672-6346
Mailing address
7411 Ashlyn Dr
Olive Branch, MS 38654-1346
Phone (901) 870-2982
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 Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3000 | MS | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687132800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689292800000",
"number": "1568147346",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7411 ASHLYN DR",
"city": "OLIVE BRANCH",
"state": "MS",
"postal_code": "386541346",
"telephone_number": "901-870-2982"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5740 GETWELL RD STE D",
"city": "SOUTHAVEN",
"state": "MS",
"postal_code": "386726346",
"telephone_number": "601-790-0583"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDERSON",
"first_name": "JULIA",
"middle_name": "MAE",
"name_prefix": "Mrs.",
"credential": "MA, LPC, BC-TMH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-06-19",
"last_updated": "2023-07-14",
"certification_date": "2023-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MS",
"license": "3000",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southaven, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 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.