Individual provider Active NPI

Kyerra Henderson, BA MHP

  • Social Worker
  • Cairo, IL
National Provider Identifier
1578041729
Registry record updated Jul 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
1401 Washington Ave
Cairo, IL 62914-1810
Phone
(618) 734-2664
Fax
(618) 734-1999
NPI assigned
Jul 31, 2018
Last updated
Jul 15, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU
Social Worker 104100000X IL Primary
Clinical Social Worker 1041C0700X 149031998 IL

Addresses

Primary practice location

1401 Washington Ave
Cairo, IL 62914-1810

Mailing address

1401 Washington Ave
Cairo, IL 62914-1810
Phone (618) 734-2664

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

510 Hempstead Tpke
RM 203
West Hempstead, NY 11552-1147

510 Hempstead Tpke RM
Suite 203
West Hempstead, NY 11552-1152

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Arts

NPI Registry JSON

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

{
    "created_epoch": "1532995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784073600000",
    "number": "1578041729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 WASHINGTON AVE",
            "city": "CAIRO",
            "state": "IL",
            "postal_code": "629141810",
            "telephone_number": "618-734-2664",
            "fax_number": "618-734-1999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 WASHINGTON AVE",
            "city": "CAIRO",
            "state": "IL",
            "postal_code": "629141810",
            "telephone_number": "618-734-2664",
            "fax_number": "618-734-1999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "KYERRA",
        "credential": "BA MHP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-31",
        "last_updated": "2026-07-15",
        "certification_date": "2026-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149031998",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cairo, IL

Sources for this page

Verify at the official NPI Registry.