Patti Gail Henderson, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

36570 Issued in TX

Practice address

2405 Texas Ave S Ste 308
College Station, TX 77840-4602

Phone

(979) 777-7499

Fax

(979) 691-5755

NPI assigned

Sep 20, 2012

Sex

Female

Sole proprietor

Yes

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 TX

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

Specialty

Clinical Psychologist

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1348099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488931200000",
    "number": "1730430455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8085 ATLAS PEAR DR APT 1218",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778071408",
            "telephone_number": "979-777-7499",
            "fax_number": "979-691-5755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2405 TEXAS AVE S STE 308",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778404602",
            "telephone_number": "979-777-7499",
            "fax_number": "979-691-5755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "PATTI",
        "middle_name": "GAIL",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-20",
        "last_updated": "2017-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "36570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carla L Heinly, MSN, APRN, PMHNP-BC
• Brittany Helmer
• Berlyn Henderson
• Christopher E Henderson, M.D.
• Kyle Henderson, MD
• Andrea Hendon, LICENSED MIDWIFE
• Lorene H Henry, MD
• Melissa Henson, PA-C
• Katie L Hepfer, PNP
• Heritage Row Chiropractic

• Clinical Psychologist in College Station, TX
• Providers in College Station, TX by specialty
• Clinical Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2017; 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.