Amy Henderson, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180008943 Issued in IL

Practice address

4500 147TH St
Midlothian, IL 60445-2646

Phone

(708) 597-0032

Fax

(708) 597-0649

NPI assigned

Jan 21, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Mar 1, 2024 through Mar 1, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Associated Counseling, LLC

  • Psychologist
  • Midlothian, IL
  • NPI 1609314830
  NPD (past)

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

{
    "created_epoch": "1390262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390262400000",
    "number": "1972926327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 147TH ST",
            "city": "MIDLOTHIAN",
            "state": "IL",
            "postal_code": "604452646",
            "telephone_number": "708-597-0032",
            "fax_number": "708-597-0649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 147TH ST",
            "city": "MIDLOTHIAN",
            "state": "IL",
            "postal_code": "604452646",
            "telephone_number": "708-597-0032",
            "fax_number": "708-597-0649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "AMY",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-21",
        "last_updated": "2014-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180008943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Kathleen Grigas
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• Harmony Care Haven
• Saad Bin Hasan
• Michelle S Hazelip, MHS, CF-SLP
• Highland Park CVS, L.L.C.
• Hines VA Hospital
• Thomas E Hines, O.D.
• Megan Hofer
• Bernetta Hughey, PHARM.D.

• All providers in Midlothian, IL
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.