Provider Demographics
NPI:1003121005
Name:HENSLEY, ALAN LUIS (PHD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:LUIS
Last Name:HENSLEY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11329 P ST # 108
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68137-2315
Mailing Address - Country:US
Mailing Address - Phone:402-650-1101
Mailing Address - Fax:402-597-2122
Practice Address - Street 1:11329 P ST # 108
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68137-2315
Practice Address - Country:US
Practice Address - Phone:402-650-1101
Practice Address - Fax:402-597-2122
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-13
Last Update Date:2011-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3925101YM0800X, 102L00000X
NE1945101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst