Reginald Quentine Henderson Sr., CSAC-I

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

3622 Lyckan Pkwy Ste 6008
Durham, NC 27707-2570

Phone

(919) 381-6816

Fax

(919) 381-6818

NPI assigned

Oct 19, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Roj Mental Health & Substance Abuse Services

  • Clinical Social Worker
  • Durham, NC
  • NPI 1437337466

  Addiction (Substance Use Disorder)

  NPD (past)

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

{
    "created_epoch": "1224374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240358400000",
    "number": "1811149099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1613 BIVINS ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277071523",
            "telephone_number": "919-224-9458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3622 LYCKAN PKWY STE 6008",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277072570",
            "telephone_number": "919-381-6816",
            "fax_number": "919-381-6818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "REGINALD",
        "middle_name": "QUENTINE",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "credential": "CSAC-I",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-19",
        "last_updated": "2009-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Therese Henderson, LCSW
• Haresha Henderson
• Jade Yearby Henderson, NP
• Jameel Henderson
• James Henderson, M.D.
• Savannah Maria Henderson, MSN, RN, CPNP-PC
• Sherry Denise Henderson, LCSW
• Wendy Owen Henderson, MD
• Henderson'S House of Hope
• Kathlene Ede Hendon, RD, LDN, CNSC

• Addiction (Substance Use Disorder) Counselor in Durham, NC
• Providers in Durham, NC by specialty
• Addiction (Substance Use Disorder) Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 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.

Verify at the official NPI Registry.