Active NPI
Robin J Henderson, PSYD
- Psychologist
- Bend, OR
National Provider Identifier
1730201880
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 1301
- Practice address
- 2542 NE Courtney Dr
Bend, OR 97701-7685 - Phone
- (541) 322-2791
- Fax
- (541) 322-4760
- NPI assigned
- Apr 6, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 1301 | OR | Primary |
Addresses
Primary practice location
2542 NE Courtney Dr
Bend, OR 97701-7685
Mailing address
2542 NE Courtney Dr
Bend, OR 97701-7685
Phone (541) 322-2791
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1301 | OR | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1730201880",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2542 NE COURTNEY DR",
"city": "BEND",
"state": "OR",
"postal_code": "977017685",
"telephone_number": "541-322-2791",
"fax_number": "541-322-4760"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2542 NE COURTNEY DR",
"city": "BEND",
"state": "OR",
"postal_code": "977017685",
"telephone_number": "541-322-2791",
"fax_number": "541-322-4760"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDERSON",
"first_name": "ROBIN",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "OR",
"license": "1301",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bend, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.