Provider Demographics
NPI:1275240707
Name:HENDERSON, CHENANIAH CURTIS (LMHC-P)
Entity Type:Individual
Prefix:
First Name:CHENANIAH
Middle Name:CURTIS
Last Name:HENDERSON
Suffix:
Gender:M
Credentials:LMHC-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2155 STATE ROUTE 22B
Mailing Address - Street 2:
Mailing Address - City:MORRISONVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12962-3417
Mailing Address - Country:US
Mailing Address - Phone:518-563-8000
Mailing Address - Fax:518-563-9001
Practice Address - Street 1:2155 STATE ROUTE 22B
Practice Address - Street 2:
Practice Address - City:MORRISONVILLE
Practice Address - State:NY
Practice Address - Zip Code:12962-3417
Practice Address - Country:US
Practice Address - Phone:518-563-8000
Practice Address - Fax:518-563-9001
Is Sole Proprietor?:No
Enumeration Date:2022-11-03
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP118361101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health