Individual provider Active NPI

Glenda R Henman, LPC

  • Mental Health Counselor
  • Phoenix, AZ
National Provider Identifier
1720674757
Registry record updated Dec 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
17954 Issued in AZ
Practice address
2936 E Turney Ave
Phoenix, AZ 85016-5852
Phone
(602) 432-3563
NPI assigned
Dec 14, 2020
Last updated
Dec 14, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 17954 AZ Primary

Addresses

Primary practice location

2936 E Turney Ave
Phoenix, AZ 85016-5852

Mailing address

2936 E Turney Ave
Phoenix, AZ 85016-5852
Phone (602) 432-3563

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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

Enrollment IDStateProvider typePAC IDDetails
I20240410002885 AZ Practitioner - Mental Health Counselor 8921446840 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17954AZMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Pathways to Connection, LLC CurrentSince Mar 9, 2024 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1607904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607904000000",
    "number": "1720674757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2936 E TURNEY AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850165852",
            "telephone_number": "602-432-3563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2936 E TURNEY AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850165852",
            "telephone_number": "602-432-3563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENMAN",
        "first_name": "GLENDA",
        "middle_name": "R",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-14",
        "last_updated": "2020-12-14",
        "certification_date": "2020-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "17954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.