Constance M. Henderson, L.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCS 18786 Issued in CA

Practice address

549 Old Mammoth Road, Suite 10
Mammoth Lakes, CA 93546-0000

Phone

(760) 934-4400

NPI assigned

Oct 10, 2006

Last updated

Feb 1, 2008By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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.

Opted out of Medicare

Yes, effective Jan 1, 2018 through Jan 1, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201824000000",
    "number": "1629166475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 284",
            "city": "LEE VINING",
            "state": "CA",
            "postal_code": "935410284",
            "telephone_number": "760-934-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "549 OLD MAMMOTH ROAD, SUITE 10",
            "city": "MAMMOTH LAKES",
            "state": "CA",
            "postal_code": "935460000",
            "telephone_number": "760-934-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "CONSTANCE",
        "middle_name": "M.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2008-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS 18786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Fenn Greenberg
• Richard Edward Hamilton Jr., M.D.
• Renee Elizabeth Hartsman, FNP
• Betty Jean Hathaway
• Mary Elizabeth Heller, R.N.,M.S.,C.F.N.P.
• Shane Hennes
• Kyle Howell, M.D.
• Christopher Hummel, M.D.
• Intouch Microspa
• Nancy Ellen Johnson

• Clinical Social Worker in Mammoth Lakes, CA
• Providers in Mammoth Lakes, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2008; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.