MEDICARE: JILL HENSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	6801086273	MI

General Provider Information

NPI Number	:	1518821115
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JILL HENSON

Provider Business Mailing Address
First Line	:	43109 BILAND DR
Second Line	:
City	:	CLINTON TOWNSHIP
State	:	MI
Zip	:	48038-5608
Country	:	US
Telephone Number	:	248-709-1520
Fax Number	:

Provider Business Practice Location Address
First Line	:	43109 BILAND DR
Second Line	:
City	:	CLINTON TOWNSHIP
State	:	MI
Zip	:	48038-5608
Country	:	US
Telephone Number	:	248-709-1520
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/10/2025
Last Update Date	:	12/10/2025

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