Individual provider Active NPI

Judith Blair Henderson, PH.D.

  • Health Service Psychologist
  • Golden Valley, MN
National Provider Identifier
1831132778
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service PsychologistTaxonomy code 103TH0100X
License
LP3720 Issued in MN
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, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
LP3720MNMDHealth Service Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Christine Gibbon, PHD, LP, LLC PastSince Mar 14, 2018 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.

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.

Verify at the official NPI Registry.