Ebonie Nicole Henderson

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C006788 Issued in NC

Practice address

7100 SW Hampton St Ste 223
Tigard, OR 97223-8364

Phone

(503) 342-2510

NPI assigned

Feb 4, 2008

Last updated

Mar 25, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Enrolled in NC, SC, WA, CO, OR, AK6 enrollments

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 6

Specialty

Clinical Social Worker

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sequim Counseling LLCGroup PAC ID 0446664627, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Sequim Counseling LLC

  dba Get Better Counseling

  • Clinical Psychologist
  • Sequim, WA
  • NPI 1558865774
  Medicare reassignment Care Compare group NPD
• Brightside Medical, P.C.

  • Psychiatry Physician
  • San Francisco, CA
  • NPI 1801355482

  SC

  Medicare reassignment NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  AK, Clinical, CO, NC, OR, SC, WA

  Medicare reassignment NPD
• Portland Relationship Institute

  dba Counseling Services of Portland

  • Mental Health Counselor
  • Tigard, OR
  • NPI 1942619655
  NPD
• Daymark Recovery Services Inc

  • Community/Behavioral Health Agency
  • Salisbury, NC
  • NPI 1487814869
  NPD (past)
• Daymark Recovery Services, Inc.

  • Multi-Specialty Clinic/Center
  • Concord, NC
  • NPI 1558329243

  Clinical

  NPD (past)

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

{
    "created_epoch": "1202083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711324800000",
    "number": "1730367616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7100 SW HAMPTON ST STE 223",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972238364",
            "telephone_number": "503-342-2510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7100 SW HAMPTON ST STE 223",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972238364",
            "telephone_number": "503-342-2510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "EBONIE",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-04",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C006788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Braylee Heisinger
• Robert Thomas Helfend
• Donna Marie Lewis Hellums, RDH
• Andrew Chase Henderson, DMD
• Diana Marie Henderson
• Marie Henderson
• Tashina Louise Hendon
• Melissa Hendricks
• Kati Hengel
• Katherine Grace Hoff Hennessy, LPC

• Clinical Social Worker in Tigard, OR
• Providers in Tigard, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.