Provider Demographics
NPI:1346371291
Name:HENDERSON, CATHY (QP, BA)
Entity Type:Individual
Prefix:MS
First Name:CATHY
Middle Name:
Last Name:HENDERSON
Suffix:
Gender:F
Credentials:QP, BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 E 7TH ST
Mailing Address - Street 2:P.O. BOX 35458
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28204-3340
Mailing Address - Country:US
Mailing Address - Phone:704-376-7180
Mailing Address - Fax:704-376-0904
Practice Address - Street 1:2200 E 7TH ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204-3340
Practice Address - Country:US
Practice Address - Phone:704-376-7180
Practice Address - Fax:704-376-0904
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker