Kimberly S Henderson, LMHP LADC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

P376 Issued in NE

Practice address

8502 Mormon Bridge Rd
Omaha, NE 68152-1929

Phone

(402) 455-8347

Fax

(402) 455-7050

NPI assigned

Feb 27, 2009

Sex

Female

Sole proprietor

Yes

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 NE

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

Mental Health Counselor

Education

Other, 2005

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Lutheran Family Services of NE, Inc

  • Mental Health Counselor
  • Omaha, NE
  • NPI 1639121726
  Medicare reassignment
• Nova Theraputic Community, Inc

  • Children's Substance Abuse Rehabilitation Facility
  • Omaha, NE
  • NPI 1457599086
  NPD (past)

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

{
    "created_epoch": "1235692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575849600000",
    "number": "1609016831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8502 MORMON BRIDGE RD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681521929",
            "telephone_number": "402-991-8558",
            "fax_number": "402-455-7050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8502 MORMON BRIDGE RD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681521929",
            "telephone_number": "402-455-8347",
            "fax_number": "402-455-7050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "KIMBERLY",
        "middle_name": "S",
        "credential": "LMHP LADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-27",
        "last_updated": "2019-12-09",
        "certification_date": "2019-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "7860",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NE",
            "license": "P376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Glynis Katherine Henderson, APRN
• Jaci Henderson, M.S., CF- SLP
• Jennifer Henderson
• Kamaya Henderson
• Kathryn Henderson, DO
• Kristen Henderson, M.S. CCC-SLP
• Kristen Henderson
• Latosha Henderson
• Latoya S Henderson
• Leah Henderson

• Addiction (Substance Use Disorder) Counselor in Omaha, NE
• Providers in Omaha, NE by specialty
• Addiction (Substance Use Disorder) Counselor in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 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.