NPIMap

Individual provider Active NPI

Cory Henning

  • Clinical Social Worker
  • Riverside, RI
National Provider Identifier
1962766154
Registry record updated Feb 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW108942 Issued in CA
Practice address
32 Buckthorne Ave
Riverside, RI 02915-3702
Phone
(401) 300-5549
NPI assigned
Jul 2, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2024

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 ASW84452 CA
Clinical Social Worker 1041C0700X LCSW108942 CA Primary

Addresses

Primary practice location

32 Buckthorne Ave
Riverside, RI 02915-3702

Mailing address

555 N Main St # 1156
Providence, RI 02904-5722

Other practice location 1

1202 Morena Blvd
Ste 300
San Diego, CA 92110-3841
Phone (619) 275-0822

Other practice location 2

137 N Cottonwood St
Woodland, CA 95695-6646
Phone (530) 631-2588

Other practice location 3

734 10th Ave
San Diego, CA 92101
Phone (619) 239-4663

Other practice location 4

1 Richmond Sq Ste 333W
Providence, RI 02906-5156
Phone (650) 521-2301

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
ASW84452CAMDMental Health Counselor
LCSW108942CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Community Research Foundation Inc Past Accepting new patients
Community Research Foundation Inc Clinical Past Accepting new patients

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": "1341187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708819200000",
    "number": "1962766154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 N MAIN ST # 1156",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029045722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 BUCKTHORNE AVE",
            "city": "RIVERSIDE",
            "state": "RI",
            "postal_code": "029153702",
            "telephone_number": "401-300-5549"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1202 Morena Blvd",
            "address_2": "Ste 300",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921103841",
            "country_code": "US",
            "telephone_number": "619-275-0822",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "137 N Cottonwood St",
            "address_purpose": "LOCATION",
            "city": "Woodland",
            "state": "CA",
            "postal_code": "956956646",
            "country_code": "US",
            "telephone_number": "530-631-2588",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "734 10th Ave",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "92101",
            "country_code": "US",
            "telephone_number": "619-239-4663",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Richmond Sq Ste 333W",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029065156",
            "country_code": "US",
            "telephone_number": "650-521-2301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENNING",
        "first_name": "CORY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-02",
        "last_updated": "2024-02-25",
        "certification_date": "2024-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "ASW84452",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW108942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2024; 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.