Antoine Maurice Henderson

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

APS.005688 Issued in OH

Practice address

815 W Broad St Ste 200
Columbus, OH 43222-1465

Phone

(216) 302-5757

NPI assigned

Feb 21, 2025

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1740096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765497600000",
    "number": "1619773538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "744 NOVA CT",
            "city": "WORTHINGTON",
            "state": "OH",
            "postal_code": "430853474",
            "telephone_number": "216-302-5757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 W BROAD ST STE 200",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432221465",
            "telephone_number": "216-302-5757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "ANTOINE",
        "middle_name": "MAURICE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-02-21",
        "last_updated": "2025-12-12",
        "certification_date": "2025-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OH",
            "license": "APS.005688",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CDCA191060",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dawn Elizabeth Hendershot
• Caprece Henderson-Ashby, LPN
• Ky'Li Matae Henderson-McKnight
• Aleathea V Henderson
• Anna Mateel Henderson
• Ashlee Henderson, APRN-CNP
• Candace Henderson
• Cassidi Renee Henderson, STNA
• Cheryl Henderson, PRS
• Corey Henderson Sr.

• Peer Specialist in Columbus, OH
• Providers in Columbus, OH by specialty
• Peer Specialist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2025; 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.