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KIMBERLY MICHELLE HENDERSON LCSW
NPI 1255956942
Social Worker - Clinical in Rockford, IL

Active since June 09, 2020PECOS Enrolled
6392 LINDEN RD, ROCKFORD, IL 61109(779) 368-0060 Get Directions Write a Review

NPPES record last updated: January 6, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 6, 2026, Dec 30, 2025, Jul 17, 2024 and 1 more (4 updates tracked since 2020).

About Kimberly Michelle Henderson Lcsw NPPES

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

KIMBERLY MICHELLE HENDERSON LCSW (NPI 1255956942) is an individual clinical provider in Rockford, Illinois, licensed in Illinois (149.030687) and active in the NPI registry since June 2020. She is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1255956942
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameKIMBERLY MICHELLE HENDERSONCredential: LCSW
Location Address6392 LINDEN RDRockford, IL 61109-2816
Mailing Address6392 Linden RdRockford, IL 61109-2816 · (779) 368-0060
Phone(779) 368-0060
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateJune 9, 2020
Last NPPES UpdateJanuary 6, 20264 updates tracked since enumeration
NPPES CertifiedJanuary 6, 2026
✔ NPI 1255956942 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in IL · 149.030687
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
6392 LINDEN RD, Rockford, IL 61109
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Other Names 1

Former Name (1)Kimberly Michelle Lewis

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kimberly Michelle Henderson Lcsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7517444599
PECOS Enrollment IDI20260121002525
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61109 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $54.80 – $168.44
Typical copayment $0.00 (range $13.70 – $42.11)
Most-billed visit code NA
Established Patient
$68.64 typical visit price
range $17.16 – $136.56
Typical copayment $17.16 (range $4.29 – $34.14)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 15

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

SONYA MCDEVITT LCPC
Counselor (Professional)
6392 LINDEN RD
ROCKFORD, IL 61109
Winnebago County (779) 368-0060
THE FIT MED EXPERIENCE
Massage Therapist
6392 LINDEN RD
ROCKFORD, IL 61109
Winnebago County (815) 540-8368
OPTUM BEHAVIORAL CARE THERAPY SERVICES OF ILLINOIS PC
Social Worker (Clinical)
6392 LINDEN RD
ROCKFORD, IL 61109
Winnebago County (779) 368-0060
AMY BRUYN LCPC
Counselor (Professional)
6392 LINDEN RD
ROCKFORD, IL 61109
Winnebago County (779) 368-0060
SAMUEL L DENTON LCSW
Social Worker (Clinical)
6392 LINDEN RD
ROCKFORD, IL 61109
Winnebago County (779) 368-0060
JENNIFER FRICKE LCSW
Social Worker (Clinical)
6392 LINDEN RD
ROCKFORD, IL 61109
Winnebago County (779) 368-0060
DELINDA GRINDLE LCSW
Social Worker (Clinical)
6392 LINDEN RD
ROCKFORD, IL 61109
Winnebago County (779) 368-0060
MS. CHARLOTTE MAE REED LCPC
Counselor (Professional)
6392 LINDEN RD
ROCKFORD, IL 61109
Winnebago County (779) 368-0060

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kimberly Henderson's NPI number?

The NPI number for Kimberly Henderson is 1255956942. It was assigned to this individual provider in the NPPES registry on June 9, 2020. The provider is also known as Kimberly Michelle Lewis.

Where is Kimberly Henderson located?

Kimberly Henderson practices at 6392 Linden Rd, Rockford, IL 61109. The listed phone number is (779) 368-0060.

What is Kimberly Henderson's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Kimberly Henderson enrolled in Medicare?

Yes. Kimberly Henderson is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kimberly Henderson was last updated on January 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months 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.