CJ Carl John Henoch

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

ASW86634 Issued in CA

Practice address

600 N Arrowhead Ave Ste 300
San Bernardino, CA 92401-1148

Phone

(909) 522-4656

NPI assigned

Jun 6, 2013

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": "1370476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614038400000",
    "number": "1639517188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 N ARROWHEAD AVE STE 200",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924011152",
            "telephone_number": "909-963-5355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N ARROWHEAD AVE STE 300",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924011148",
            "telephone_number": "909-522-4656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENOCH",
        "first_name": "CJ",
        "middle_name": "CARL JOHN",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-06",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "86634",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "ASW86634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Celine Hendricks
• Starla Elizabeth Hendrix
• Madison Henery
• Charitie Lovee Hennig
• William Walter Henning, D.O.
• Kimberly Yoselyne Henriquez Pinto
• Jennifer Maristela Henry
• Rhonita Henry, FNP-C
• Jon Michael Hensley
• Lauren Henson

• Mental Health Counselor in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2021; 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.