Individual provider Active NPI

Annette Elizabeth Henke, LCSW

  • Clinical Social Worker
  • Sacramento, CA
National Provider Identifier
1912162058
Registry record updated Jun 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS16586 Issued in CA
Practice address
2609 Capitol Ave
Ste.3
Sacramento, CA 95816-5904
Phone
(916) 422-4814
Fax
(707) 265-8784
NPI assigned
Jul 28, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCS16586 CA Primary

Addresses

Primary practice location

2609 Capitol Ave
Ste.3
Sacramento, CA 95816-5904

Mailing address

1420 Third St
Ste 2
Napa, CA 94559-2859
Phone (707) 927-1574

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20160708000045 CA Order and Referring Only - Clinical Social Worker 6406148675

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS16586CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1217203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466294400000",
    "number": "1912162058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 THIRD ST",
            "address_2": "STE 2",
            "city": "NAPA",
            "state": "CA",
            "postal_code": "945592859",
            "telephone_number": "707-927-1574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2609 CAPITOL AVE",
            "address_2": "STE.3",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958165904",
            "telephone_number": "916-422-4814",
            "fax_number": "707-265-8784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENKE",
        "first_name": "ANNETTE",
        "middle_name": "ELIZABETH",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-28",
        "last_updated": "2016-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS16586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.