Provider Demographics
NPI:1497703979
Name:HENNIG, ERIC STEPHEN (EDD, LMFT)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:STEPHEN
Last Name:HENNIG
Suffix:
Gender:M
Credentials:EDD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 CHRIS LN
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-7445
Mailing Address - Country:US
Mailing Address - Phone:407-839-4766
Mailing Address - Fax:407-423-0221
Practice Address - Street 1:703 E PINE ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32801-2943
Practice Address - Country:US
Practice Address - Phone:407-839-4766
Practice Address - Fax:407-423-0221
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY3069101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health