Provider Demographics
NPI:1235453796
Name:HENDERSON, BETSY J (MA, LCMFT, LCAC)
Entity Type:Individual
Prefix:DR
First Name:BETSY
Middle Name:J
Last Name:HENDERSON
Suffix:
Gender:F
Credentials:MA, LCMFT, LCAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8901 CRAIG DRIVE
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66212-3701
Mailing Address - Country:US
Mailing Address - Phone:858-263-9105
Mailing Address - Fax:
Practice Address - Street 1:8901 CRAIG DRIVE
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66212-3701
Practice Address - Country:US
Practice Address - Phone:858-263-9105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-26
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 48032106H00000X
KS2954106H00000X
MO2020002712106H00000X
KS00817101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)