Provider Demographics
NPI:1114534716
Name:HENSON, BETH ANNE (MSW, BCD)
Entity Type:Individual
Prefix:MS
First Name:BETH
Middle Name:ANNE
Last Name:HENSON
Suffix:
Gender:F
Credentials:MSW, BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2717 UNICORN LN NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20015-2233
Mailing Address - Country:US
Mailing Address - Phone:120-230-9033
Mailing Address - Fax:
Practice Address - Street 1:2717 UNICORN LN NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20015-2233
Practice Address - Country:US
Practice Address - Phone:120-230-9033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-28
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC303391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical