Active NPI
Judith Blair Henderson, PH.D.
- Health Service Psychologist
- Golden Valley, MN
National Provider Identifier
1831132778
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Service Psychologist
- License
- LP3720
- Practice address
- 5101 Olson Memorial Hwy
Suite 4002
Golden Valley, MN 55422-5149 - Phone
- (763) 595-7294
- Fax
- (763) 595-7293
- NPI assigned
- Jun 14, 2006
- Last updated
- Jul 13, 2026
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Health Service Psychologist | 103TH0100X | LP3720 | MN | Primary |
Addresses
Primary practice location
5101 Olson Memorial Hwy
Suite 4002
Golden Valley, MN 55422-5149
Mailing address
5101 Olson Memorial Hwy
Suite 4002
Golden Valley, MN 55422-5149
Phone (763) 595-7294
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
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP3720 | MN | MD | Health Service Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Christine Gibbon, PHD, LP, LLC | Past | Accepting new patients | |
| Lynda Richtsmeier Cyr, PH.D., L.P., LLC | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Clinical Psychologist
- Golden Valley, MN
- NPI 1346613478
-
- Adolescent and Children Mental Health Clinic/Center
- Golden Valley, MN
- NPI 1659542884
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1831132778",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5101 OLSON MEMORIAL HWY",
"address_2": "SUITE 4002",
"city": "GOLDEN VALLEY",
"state": "MN",
"postal_code": "554225149",
"telephone_number": "763-595-7294",
"fax_number": "763-595-7293"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5101 OLSON MEMORIAL HWY",
"address_2": "SUITE 4002",
"city": "GOLDEN VALLEY",
"state": "MN",
"postal_code": "554225149",
"telephone_number": "763-595-7294",
"fax_number": "763-595-7293"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDERSON",
"first_name": "JUDITH",
"middle_name": "BLAIR",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-14",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "103TH0100X",
"taxonomy_group": "",
"desc": "Psychologist, Health Service",
"state": "MN",
"license": "LP3720",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Golden Valley, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.