Provider Demographics
NPI:1124398565
Name:HENDERSON, JESSICA CLAUDETTE (MS, LMFT)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:CLAUDETTE
Last Name:HENDERSON
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3316 MOUNT VERNON ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77006-3829
Mailing Address - Country:US
Mailing Address - Phone:713-526-8390
Mailing Address - Fax:
Practice Address - Street 1:3316 MOUNT VERNON ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006-3829
Practice Address - Country:US
Practice Address - Phone:713-526-8390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-02
Last Update Date:2012-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX201496106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist