Jack J Henderson, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

11678 Issued in TX

Practice address

1910 Westmead Drive
3510
Houston, TX 77077-4724

Phone

(832) 643-3256

Fax

(281) 809-5854

NPI assigned

Oct 11, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

My Bright Future, LLCGroup PAC ID 0648537936, 5 clinicians

Your Opportunities Unlimited IncGroup PAC ID 0648748764, 2 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 and National Provider Directory roles.

• My Bright Future, LLC

  • Prescribing (Medical) Psychologist
  • Houston, TX
  • NPI 1225549413
  Medicare reassignment Care Compare group NPD
• Your Opportunities Unlimited Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Houston, TX
  • NPI 1841157120
  Care Compare group
• Progressive Behavioral Health, PLLC

  • Mental Health Counselor
  • Friendswood, TX
  • NPI 1659567238

  Professional

  NPD

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

{
    "created_epoch": "1192060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412899200000",
    "number": "1891983151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 WESTMEAD DRIVE",
            "address_2": "3510",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770774724",
            "telephone_number": "832-643-3256",
            "fax_number": "281-809-5854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 WESTMEAD DRIVE",
            "address_2": "3510",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770774724",
            "telephone_number": "832-643-3256",
            "fax_number": "281-809-5854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "JACK",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-11",
        "last_updated": "2014-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "11678",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "TX",
            "license": "3334",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112950407",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elspeth Henderson
• Emily Henderson
• Floyd Tyrone Henderson II, LPC
• Heidi Elizabeth Henderson, FNP-BC, APRN-CNP
• Hunter Danielle Henderson
• Jamie Monet Henderson, LCSW
• Janee V. Henderson, LPC
• Jasmyne Denea Henderson, M.S. CCC-SLP
• Jerry D. Henderson, M.D.
• Jessica Claudette Henderson, M.S., LMFT

• Professional Counselor in Houston, TX
• Providers in Houston, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2014; 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.