Provider Demographics
NPI:1497918882
Name:HENSLEY, BRENDA SUE (CADC)
Entity Type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:SUE
Last Name:HENSLEY
Suffix:
Gender:F
Credentials:CADC
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 1182
Mailing Address - Street 2:
Mailing Address - City:GUTHRIE
Mailing Address - State:OK
Mailing Address - Zip Code:73044-1182
Mailing Address - Country:US
Mailing Address - Phone:405-282-8232
Mailing Address - Fax:405-282-3305
Practice Address - Street 1:1916 E PERKINS AVE
Practice Address - Street 2:
Practice Address - City:GUTHRIE
Practice Address - State:OK
Practice Address - Zip Code:73044-5804
Practice Address - Country:US
Practice Address - Phone:405-282-8232
Practice Address - Fax:405-282-3305
Is Sole Proprietor?:No
Enumeration Date:2008-07-07
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK400101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)