Marion Robert Henderson
Individual provider Active NPI Mental Health Counselor · Edgefield, SC
NPI 1942392295 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1942392295
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Practice address
- 409 Simpkins St
Edgefield, SC 29824-1313 - Phone
- (803) 637-5338
- Fax
- (803) 637-0753
- NPI assigned
- Sep 28, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Carolina Dept of Mental Health Accounting Office | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Yes |
Addresses
Primary practice location
409 Simpkins St
Edgefield, SC 29824-1313
Mailing address
1547 Parkway
Suite100
Greenwood, SC 29646-4081
Phone (864) 229-7120
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 421504 | Medicaid | SC |
Other providers in Edgefield, SC
- Family Dentistry of Edgefield
- Federal Bureau of Prisons
- Elizabeth S Gordineer
- Jeffery Reed Gosney
- Halcyon Supply Co., LLC
- Karen Anderson Hickman
- Corinthian Hillary
- Kim Massey Holsomback
- Renita Irving
- Jeffrey R Geer OD PC
All providers in Edgefield, SC · Mental Health Counselor in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.