Provider Demographics
NPI:1346805488
Name:HENDERSON, BRITTANY DIANE (LPCC)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:DIANE
Last Name:HENDERSON
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:665 KINGFISHER LN APT C
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-1843
Mailing Address - Country:US
Mailing Address - Phone:651-703-1681
Mailing Address - Fax:
Practice Address - Street 1:4255 PHEASANT RIDGE DR NE STE 412
Practice Address - Street 2:
Practice Address - City:BLAINE
Practice Address - State:MN
Practice Address - Zip Code:55449-5066
Practice Address - Country:US
Practice Address - Phone:763-703-3754
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-03
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program