Provider Demographics
NPI:1235616590
Name:HENSON, PORSCHA TENEYEK (LPC, LCPC, RPT)
Entity Type:Individual
Prefix:MRS
First Name:PORSCHA
Middle Name:TENEYEK
Last Name:HENSON
Suffix:
Gender:F
Credentials:LPC, LCPC, RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:648 WILBUR SQ
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-2478
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:205 BLOOMSBURY AVE
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-5223
Practice Address - Country:US
Practice Address - Phone:410-744-1083
Practice Address - Fax:410-455-0071
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-19
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6050101YP2500X
MDLC6987101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional