Active NPI
Cheryl Henderson, PSYD
- Clinical Psychologist
- Old Saybrook, CT
National Provider Identifier
1851520159
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 001582
- Practice address
- 20 Research Pkwy
Suite C
Old Saybrook, CT 06475-4214 - Phone
- (800) 370-3651
- Fax
- (860) 510-0020
- NPI assigned
- Jul 8, 2009
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 001582 | CT | Primary |
Addresses
Primary practice location
20 Research Pkwy
Suite C
Old Saybrook, CT 06475-4214
Mailing address
20 Research Pkwy
Suite C
Old Saybrook, CT 06475-4214
Phone (800) 370-3651
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001582 | CT | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1247011200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1247011200000",
"number": "1851520159",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20 RESEARCH PKWY",
"address_2": "SUITE C",
"city": "OLD SAYBROOK",
"state": "CT",
"postal_code": "064754214",
"telephone_number": "800-370-3651",
"fax_number": "860-510-0020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 RESEARCH PKWY",
"address_2": "SUITE C",
"city": "OLD SAYBROOK",
"state": "CT",
"postal_code": "064754214",
"telephone_number": "800-370-3651",
"fax_number": "860-510-0020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDERSON",
"first_name": "CHERYL",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-07-08",
"last_updated": "2009-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CT",
"license": "001582",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Old Saybrook, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.