Provider Demographics
NPI:1356823801
Name:HENDERSON, BRITTNEY CLARISSE (LMFT)
Entity Type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:CLARISSE
Last Name:HENDERSON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4211 BLACKWOOD ST
Mailing Address - Street 2:
Mailing Address - City:NEWBURY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91320-4910
Mailing Address - Country:US
Mailing Address - Phone:310-697-6264
Mailing Address - Fax:
Practice Address - Street 1:13701 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91423-2430
Practice Address - Country:US
Practice Address - Phone:310-697-6264
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-31
Last Update Date:2018-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA104401106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist