Individual provider Active NPI

Kenisha Henderson, LCSW

  • Massage Therapist
  • McKinney, TX
National Provider Identifier
1891247672
Registry record updated Aug 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MT131288 Issued in TX
Practice address
5500 McKinney Place Dr Apt 109
McKinney, TX 75070-2170
Phone
(773) 414-3586
NPI assigned
Oct 27, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 17, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 67712 TX
Massage Therapist 225700000X 227016133 IL
Massage Therapist 225700000X MT131288 TX Primary

Addresses

Primary practice location

5500 McKinney Place Dr Apt 109
McKinney, TX 75070-2170

Mailing address

5500 McKinney Place Dr Apt 109
McKinney, TX 75070-2170
Phone (773) 414-3586

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

State licenses

LicenseStateTypeSpecialty
67712TXMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
227016133ILMDMassage Therapist
MT131288TXMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Institute for Health Evaluation and Research Unlimited LLC PastSince May 16, 2022 Accepting new patients

Organizations & group practices 1

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": "1477526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692230400000",
    "number": "1891247672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 MCKINNEY PLACE DR APT 109",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750702170",
            "telephone_number": "773-414-3586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 MCKINNEY PLACE DR APT 109",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750702170",
            "telephone_number": "773-414-3586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "KENISHA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-27",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "67712",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "IL",
            "license": "227016133",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "TX",
            "license": "MT131288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McKinney, TX

Sources for this page

Verify at the official NPI Registry.