Individual provider Active NPI

Michelle Christine Henderson, M.A.

  • Mental Health Counselor
  • Bothell, WA
National Provider Identifier
1730580903
Registry record updated Jul 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
18221 102ND Ave NE
Bothell, WA 98011-3466
Phone
(425) 375-1704
NPI assigned
Sep 8, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 6, 2019

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 Primary

Addresses

Primary practice location

18221 102ND Ave NE
Bothell, WA 98011-3466

Mailing address

18221 102ND Ave NE
Bothell, WA 98011-3466
Phone (425) 375-1704

Other practice location 1

4807 196th St SW
Suite 220
Lynnwood, WA 98036-6430
Phone (425) 835-5850

Other names 1

  • Ms. Michelle Christine Terry Former name

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
Credentials
Master of Arts

NPI Registry JSON

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

{
    "created_epoch": "1410134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562371200000",
    "number": "1730580903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18221 102ND AVE NE",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980113466",
            "telephone_number": "425-375-1704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18221 102ND AVE NE",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980113466",
            "telephone_number": "425-375-1704"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4807 196th St SW",
            "address_2": "Suite 220",
            "address_purpose": "LOCATION",
            "city": "Lynnwood",
            "state": "WA",
            "postal_code": "980366430",
            "country_code": "US",
            "telephone_number": "425-835-5850",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "MICHELLE",
        "middle_name": "CHRISTINE",
        "name_prefix": "Mrs.",
        "credential": "M.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-08",
        "last_updated": "2019-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "TERRY",
            "middle_name": "CHRISTINE",
            "prefix": "MS.",
            "credential": "M.A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bothell, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2019; 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.