Provider Demographics
NPI:1518003219
Name:HENRY, CAROL JANET (PHD)
Entity Type:Individual
Prefix:DR
First Name:CAROL
Middle Name:JANET
Last Name:HENRY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2107 ELLIOTT AVE
Mailing Address - Street 2:SUITE 309
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98121-2186
Mailing Address - Country:US
Mailing Address - Phone:206-441-3121
Mailing Address - Fax:206-441-6147
Practice Address - Street 1:2107 ELLIOTT AVE
Practice Address - Street 2:SUITE 309
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98121-2186
Practice Address - Country:US
Practice Address - Phone:206-441-3121
Practice Address - Fax:206-441-6147
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA831103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling