Provider Demographics
NPI:1225463508
Name:HENDERSON, DEANNA (LPC, CRC)
Entity Type:Individual
Prefix:DR
First Name:DEANNA
Middle Name:
Last Name:HENDERSON
Suffix:
Gender:F
Credentials:LPC, CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100-E BRANDYWINE BLVD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701
Mailing Address - Country:US
Mailing Address - Phone:740-297-7800
Mailing Address - Fax:740-297-7228
Practice Address - Street 1:1100 BRANDYWINE BLVD
Practice Address - Street 2:SUITE 3
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-7303
Practice Address - Country:US
Practice Address - Phone:740-297-7800
Practice Address - Fax:740-297-7228
Is Sole Proprietor?:No
Enumeration Date:2013-09-05
Last Update Date:2013-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC0600510101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional