Provider Demographics
NPI:1407966427
Name:HENDERSON, GAYE ELLEN (MT-BC, LPC)
Entity Type:Individual
Prefix:MS
First Name:GAYE
Middle Name:ELLEN
Last Name:HENDERSON
Suffix:
Gender:F
Credentials:MT-BC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9229 WARD PARKWAY
Mailing Address - Street 2:SUITE 225
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64114-3311
Mailing Address - Country:US
Mailing Address - Phone:816-444-5511
Mailing Address - Fax:816-822-8058
Practice Address - Street 1:9229 WARD PARKWAY
Practice Address - Street 2:SUITE 225
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-3311
Practice Address - Country:US
Practice Address - Phone:816-444-5511
Practice Address - Fax:816-822-8058
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2014-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO002419101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor