Individual provider Active NPI

Donna Cate Henderson, L.C.S.W.

  • Clinical Social Worker
  • Maupin, OR
National Provider Identifier
1821154873
Registry record updated Nov 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0995 Issued in OR
Practice address
1101 N. Highway 197
Maupin, OR 97037-9703
Phone
(503) 510-3789
Fax
(866) 490-5249
NPI assigned
Dec 27, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0995 OR Primary

Addresses

Primary practice location

1101 N. Highway 197
Maupin, OR 97037-9703

Mailing address

PO Box 372
Maupin, OR 97037-0372
Phone (503) 510-3789

Other identifiers 2

IdentifierTypeStateIssuer
082565000OtherORREGENCE BCBSO PROVIDER #
267590OtherVAVALUE OPTIONS PROVIDER #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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

Enrollment IDStateProvider typePAC IDDetails
I20050830001056 OR Practitioner - Clinical Social Worker 0244261121 Practice locations: Maupin, OR

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1101 N Hwy 197
Maupin, OR 97037-0372
Phone (503) 510-3789

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0995ORMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Donna Henderson, LCSW Clinical PastSince Dec 5, 2016 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574812800000",
    "number": "1821154873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 372",
            "city": "MAUPIN",
            "state": "OR",
            "postal_code": "970370372",
            "telephone_number": "503-510-3789",
            "fax_number": "866-490-5249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 N. HIGHWAY 197",
            "city": "MAUPIN",
            "state": "OR",
            "postal_code": "970379703",
            "telephone_number": "503-510-3789",
            "fax_number": "866-490-5249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "DONNA",
        "middle_name": "CATE",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-27",
        "last_updated": "2019-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "0995",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BCBSO PROVIDER #",
            "identifier": "082565000",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS PROVIDER #",
            "identifier": "267590",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maupin, OR

Sources for this page

Verify at the official NPI Registry.