Michelle R. Henriques, PH.D., LCSW, LCDC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

55290 Issued in TX

Practice address

6600 Van Aalst Blvd
Fort Moore, GA 31905-2102

Phone

(404) 644-1225

NPI assigned

Mar 6, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1362528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737590400000",
    "number": "1730420340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 PORTICO PL",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302655944",
            "telephone_number": "404-644-1225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6600 VAN AALST BLVD",
            "city": "FORT MOORE",
            "state": "GA",
            "postal_code": "319052102",
            "telephone_number": "404-644-1225"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "71 Portico Pl",
            "address_purpose": "LOCATION",
            "city": "Newnan",
            "state": "GA",
            "postal_code": "302655944",
            "country_code": "US",
            "telephone_number": "404-644-1225",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENRIQUES",
        "first_name": "MICHELLE",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "PH.D., LCSW, LCDC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-06",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "11588",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW23402",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "55290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Georgia Megan Harrison, MSW, LCSW
• Karnisha Harvey
• John Clay Hastings, D.M.D.
• Tamika Lashun Helton, ACNP
• Eric Henderson
• Brendon Christopher Henry, MD
• Kassandra Hill, LICSW
• Reginald Hill, PSY. D., MSW, LCSW
• Cassandra Jane Holdcroft, LPC
• Beulette Yvonne Hooks, M.D.

• Clinical Social Worker in Fort Moore, GA
• Providers in Fort Moore, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2025; 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.