Provider Demographics
NPI:1346665296
Name:HENDERSON, DORA LYNN (LMHC)
Entity Type:Individual
Prefix:
First Name:DORA
Middle Name:LYNN
Last Name:HENDERSON
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142 CIRCLE HILL RD
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32773-4770
Mailing Address - Country:US
Mailing Address - Phone:407-863-2121
Mailing Address - Fax:
Practice Address - Street 1:1250 S US HIGHWAY 17 92 STE 150
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32750-5712
Practice Address - Country:US
Practice Address - Phone:407-863-2121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-02
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 12311101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health