Trude Hendrickson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1571 Issued in ND

Practice address

2451 E Baseline Rd Ste 200
Gilbert, AZ 85234-2405

Phone

(480) 507-2199

Fax

(480) 507-2218

NPI assigned

Jul 23, 2009

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/GBGIBD

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.

• Canyon Pediatrics, Inc

  • Pediatrics Physician
  • Gilbert, AZ
  • NPI 1053176677
  NPD
• Canyon Pediatrics, Inc

  • Primary Care Clinic/Center
  • Gilbert, AZ
  • NPI 1831185362
  NPD
• Prairie St Johns

  • Psychiatric Hospital
  • Fargo, ND
  • NPI 1417901000
  NPD (past)
• Village Family Service Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fargo, ND
  • NPI 1568492353

  Clinical

  NPD (past)
• Village Family Service Center

  • Substance Abuse Rehabilitation Facility
  • Fargo, ND
  • NPI 1952679318
  NPD (past)

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

{
    "created_epoch": "1248307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611187200000",
    "number": "1912137019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2451 E BASELINE RD STE 130",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852342487",
            "telephone_number": "480-507-2199",
            "fax_number": "480-507-2218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2451 E BASELINE RD STE 200",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852342405",
            "telephone_number": "480-507-2199",
            "fax_number": "480-507-2218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRICKSON",
        "first_name": "TRUDE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-23",
        "last_updated": "2021-01-21",
        "certification_date": "2021-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ND",
            "license": "1571",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZ LICENSE",
            "identifier": "LCSW-18650",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Saira Punjwani Hemani, PA-C
• Cassandra Lynn Henderson, PA-C
• Grace Olivia Hendricks
• Hendrickson Hearing LLC
• Dylan Hendrickson, HADE
• Wade Lars Hendrickson, BC-HIS
• Alyssa Hendrieth
• Libbie Henrie
• Alma Irene Henriques
• Jonathan U Henriquez, MSN,NP-C

• Clinical Social Worker in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Clinical Social Worker in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2021; 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.