Provider Demographics
NPI:1043347693
Name:HENRY, HOWARD JULIAN (MSW)
Entity Type:Individual
Prefix:MR
First Name:HOWARD
Middle Name:JULIAN
Last Name:HENRY
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 E 162ND ST
Mailing Address - Street 2:SUITE 207
Mailing Address - City:SOUTH HOLLAND
Mailing Address - State:IL
Mailing Address - Zip Code:60473-2471
Mailing Address - Country:US
Mailing Address - Phone:708-225-1237
Mailing Address - Fax:708-225-1338
Practice Address - Street 1:900 E 162ND ST
Practice Address - Street 2:SUITE 207
Practice Address - City:SOUTH HOLLAND
Practice Address - State:IL
Practice Address - Zip Code:60473-2471
Practice Address - Country:US
Practice Address - Phone:708-225-1237
Practice Address - Fax:708-225-1338
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor