Individual provider Active NPI

Alexandria Nicole Henson

  • Professional Counselor
  • Chicago, IL
National Provider Identifier
1952005258
Registry record updated Mar 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180.015982 Issued in IL
Practice address
4055 W Peterson Ave Ste 202
Chicago, IL 60646-6183
Phone
(773) 774-4444
NPI assigned
Mar 29, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 178.015839 IL
Professional Counselor 101YP2500X 180.015982 IL Primary

Addresses

Primary practice location

4055 W Peterson Ave Ste 202
Chicago, IL 60646-6183

Mailing address

4880 N Ashland Ave Apt 3E
Chicago, IL 60640-3452
Phone (314) 600-5005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20240808004022 IL Practitioner - Mental Health Counselor 1850838798 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
178.015839ILMDMental Health Counselor
180.015982ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Urban Wellness, LTD. Professional CurrentSince Apr 6, 2023 Accepting new patients
Grow Healthcare Group PA Mental Health CurrentSince Aug 27, 2024 Accepting new patients

Locations

605 N Michigan Ave
Fl 4
Chicago, IL 60611
Phone (773) 232-5338

4055 W Peterson Ave
Ste 202
Chicago, IL 60646
Phone (773) 774-4447

Organizations & group practices 2

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": "1680048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743120000000",
    "number": "1952005258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4880 N ASHLAND AVE APT 3E",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606403452",
            "telephone_number": "314-600-5005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4055 W PETERSON AVE STE 202",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606466183",
            "telephone_number": "773-774-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENSON",
        "first_name": "ALEXANDRIA",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-29",
        "last_updated": "2025-03-28",
        "certification_date": "2025-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "178.015839",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.015982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.