Tina Lucille Henderson, PMHNP-BC

Primary specialty

Geropsychiatric Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0813X

License

0024178041 Issued in VA

Practice address

169 Suffolk Ave Ste 1
Richlands, VA 24641-2434

Phone

(276) 821-2260

NPI assigned

Aug 16, 2019

Last updated

Aug 26, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Healing Waters Counseling CenterGroup PAC ID 9931362399, 16 clinicians

Southwest Regional Counseling Service IncGroup PAC ID 9133525967, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Healing Waters Counseling Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Richlands, VA
  • NPI 1124329388
  Medicare reassignment Care Compare group NPD
• Southwest Regional Counseling Service Inc

  • Addiction (Substance Use Disorder) Counselor
  • Lebanon, VA
  • NPI 1063078855
  Medicare reassignment Care Compare group NPD
• NP Partners L.L.C.

  • Family Nurse Practitioner
  • Pittsburgh, PA
  • NPI 1124569488
  NPD (past)

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

{
    "created_epoch": "1565913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756166400000",
    "number": "1831745611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1981 SCRATCH GRAVEL RD",
            "city": "MARION",
            "state": "VA",
            "postal_code": "243547015",
            "telephone_number": "276-780-4946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 SUFFOLK AVE STE 1",
            "city": "RICHLANDS",
            "state": "VA",
            "postal_code": "246412434",
            "telephone_number": "276-821-2260"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "112 E Main St",
            "address_purpose": "LOCATION",
            "city": "Abingdon",
            "state": "VA",
            "postal_code": "242102808",
            "country_code": "US",
            "telephone_number": "276-963-0111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "106 Spring Ave NE",
            "address_purpose": "LOCATION",
            "city": "Wise",
            "state": "VA",
            "postal_code": "242937527",
            "country_code": "US",
            "telephone_number": "276-963-0111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1114 E Main St",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "VA",
            "postal_code": "242665014",
            "country_code": "US",
            "telephone_number": "276-883-5050",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "510 W Main St",
            "address_purpose": "LOCATION",
            "city": "Wytheville",
            "state": "VA",
            "postal_code": "243822209",
            "country_code": "US",
            "telephone_number": "276-821-2260",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "TINA",
        "middle_name": "LUCILLE",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-16",
        "last_updated": "2025-08-26",
        "certification_date": "2025-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0813X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Geropsychiatric",
            "state": "VA",
            "license": "0024178041",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "0024178041",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF NURSING",
            "identifier": "0024178041",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "eccs24210@gmail.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1114 E Main St",
            "city": "Lebanon",
            "state": "VA",
            "country_code": "US",
            "postal_code": "242665014",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Angela Hendricks Harrison, CFNP
• Glenn A Harrison, DDS
• Jennifer Lynn Hatfield-Adkins, MSN, APRN, FNP-C
• Lyon Tige Hazleton, CRNA
• Healing Waters Counseling Center
• Hill Creek Assisted Living LLC
• Kenneth Forbes Hill, M.D.
• Home Nursing Care, Inc (Community Home Care Services)
• Danny Honaker
• Michele Annette Honaker

• Clinical Nurse Specialist in Richlands, VA
• Providers in Richlands, VA by specialty
• Clinical Nurse Specialist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.