MRS. SANDRA JACKSON HENRY
NPI 1124476510
Counselor - Mental Health in Simpsonville, SC

Q: What is Sandra Henry's NPI number?

The NPI number for Sandra Henry is 1124476510. It was assigned to this individual provider in the NPPES registry on May 26, 2016. The provider is also known as Miss Sandra Sabrina Jackson.

Q: What is Sandra Henry's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Q: When was this NPI record last updated?

The NPPES record for Sandra Henry was last updated on August 4, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 26, 2016PECOS Enrolled

879 NE MAIN ST STE A, SIMPSONVILLE, SC 29681(864) 688-9416(844) 300-6266 Get Directions Write a Review

NPPES record last updated: August 4, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Mrs. Sandra Jackson Henry NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. SANDRA JACKSON HENRY (NPI 1124476510) is an individual mental health provider in Simpsonville, South Carolina, licensed in South Carolina (8841) and active in the NPI registry since May 2016. She is enrolled in Medicare PECOS, maintains a secondary practice location in Effingham, and is a graduate of Other (2010).

NPPES Registry Identity

NPI1124476510

Entity TypeIndividualFemale

Primary Taxonomy101YM0800X

Provider Legal NameMRS. SANDRA JACKSON HENRY

Location Address879 NE MAIN ST STE ASimpsonville, SC 29681-2056

Mailing Address1735 Saint Julian Pl Ste 300Columbia, SC 29204-2402 · (803) 708-5081

Phone(864) 688-9416

Fax(844) 300-6266

Sole ProprietorNo

Medical School CMSOtherGraduated 2010

Enumeration DateMay 26, 2016

Last NPPES UpdateAugust 4, 2023

NPPES CertifiedAugust 3, 2023

✔ NPI 1124476510 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

License✔ Licensed in SC · 8841

Also ListedCounselorTaxonomy 101Y00000X · License 8841 (SC)

Also ListedCounselor · ProfessionalTaxonomy 101YP2500X · License 8841 (SC)

879 NE MAIN ST STE A, Simpsonville, SC 29681

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Other Names 1

Former Name (1)Miss Sandra Sabrina Jackson

Secondary Practice Location 1

Location 13053 Cobblestone StreetEffingham, SC 29541-4483 · Phone (803) 609-7951

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Sandra Jackson Henry is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8426533571

PECOS Enrollment IDI20260326003713

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LAUREN HEGG

Counselor (Professional)