Individual provider Active NPI

Khajae Shanice Henry, LCSW

  • Clinical Social Worker
  • Indianapolis, IN
National Provider Identifier
1821802356
Registry record updated Feb 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
222 E Ohio St Ste 100
Indianapolis, IN 46204-2193
Phone
(317) 882-5122
NPI assigned
Feb 5, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2025

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 Primary

Addresses

Primary practice location

222 E Ohio St Ste 100
Indianapolis, IN 46204-2193

Mailing address

8320 Madison Ave
Indianapolis, IN 46227-6066
Phone (317) 882-5122

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Adult and Child Mental Health Center Inc CurrentSince Feb 1, 2025 Accepting new patients
Adult and Child Mental Health Center Inc CurrentSince Feb 1, 2025 Accepting new patients

Locations

8320 Madison Ave
Indianapolis, IN 46227
Phone (317) 881-7061

5839 E Washington St
Indianapolis, IN 46219
Phone (317) 275-8880

222 E Ohio St
Ste 100
Indianapolis, IN 46204
Phone (317) 275-8880

Organizations & group practices 2

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": "1738713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738713600000",
    "number": "1821802356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8320 MADISON AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462276066",
            "telephone_number": "317-882-5122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 E OHIO ST STE 100",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462042193",
            "telephone_number": "317-882-5122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "KHAJAE",
        "middle_name": "SHANICE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-05",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.