Provider Demographics
NPI:1144569161
Name:HENDERSON, JENAH C (MA LMFT)
Entity Type:Individual
Prefix:MRS
First Name:JENAH
Middle Name:C
Last Name:HENDERSON
Suffix:
Gender:F
Credentials:MA LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 E HALEY ST STE E
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-2347
Mailing Address - Country:US
Mailing Address - Phone:805-705-2784
Mailing Address - Fax:
Practice Address - Street 1:114 E HALEY ST STE E
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-2347
Practice Address - Country:US
Practice Address - Phone:805-705-2784
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-12
Last Update Date:2019-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT95737106H00000X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist