Provider Demographics
NPI:1285185405
Name:HENDERSON, JOSHUA (BE)
Entity Type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:
Last Name:HENDERSON
Suffix:
Gender:M
Credentials:BE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2601 AMAZON ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70114-6204
Mailing Address - Country:US
Mailing Address - Phone:504-810-9636
Mailing Address - Fax:
Practice Address - Street 1:2231 CANAL ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-7601
Practice Address - Country:US
Practice Address - Phone:844-239-3737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-24
Last Update Date:2019-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator