Provider Demographics
NPI:1497056568
Name:HENDERSON, JAIME LYNN (LPCC, LMHC, LCPC)
Entity Type:Individual
Prefix:MISS
First Name:JAIME
Middle Name:LYNN
Last Name:HENDERSON
Suffix:
Gender:F
Credentials:LPCC, LMHC, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2780
Mailing Address - Street 2:
Mailing Address - City:SEBASTOPOL
Mailing Address - State:CA
Mailing Address - Zip Code:95473-2780
Mailing Address - Country:US
Mailing Address - Phone:413-561-5675
Mailing Address - Fax:
Practice Address - Street 1:4601 DAYWALT RD
Practice Address - Street 2:
Practice Address - City:SEBASTOPOL
Practice Address - State:CA
Practice Address - Zip Code:95472-6016
Practice Address - Country:US
Practice Address - Phone:413-561-5675
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-05
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health