Active NPI
Clayton Eugene Henderson, MS CCC SLP
- Speech-Language Pathologist
- Weirton, WV
National Provider Identifier
1770718306
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SLP-1170
- Practice address
- 601 Colliers Way
Weirton, WV 26062-5014 - Phone
- (304) 797-6104
- NPI assigned
- May 27, 2009
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SLP-1170 | WV | Primary |
Addresses
Primary practice location
601 Colliers Way
Weirton, WV 26062-5014
Mailing address
219 Redfield Dr
Oakdale, PA 15071-1731
Phone (724) 307-3367
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 Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SLP-1170 | WV | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1243382400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1243382400000",
"number": "1770718306",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "219 REDFIELD DR",
"city": "OAKDALE",
"state": "PA",
"postal_code": "150711731",
"telephone_number": "724-307-3367"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 COLLIERS WAY",
"city": "WEIRTON",
"state": "WV",
"postal_code": "260625014",
"telephone_number": "304-797-6104"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDERSON",
"first_name": "CLAYTON",
"middle_name": "EUGENE",
"credential": "MS CCC SLP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-05-27",
"last_updated": "2009-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "WV",
"license": "SLP-1170",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Weirton, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.