Provider Demographics
NPI:1518192673
Name:HENSLEY, ELIZABETH MAURINE (MS)
Entity Type:Individual
Prefix:MISS
First Name:ELIZABETH
Middle Name:MAURINE
Last Name:HENSLEY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:902 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WEST FRANKFORT
Mailing Address - State:IL
Mailing Address - Zip Code:62896-2210
Mailing Address - Country:US
Mailing Address - Phone:618-937-6483
Mailing Address - Fax:618-937-1440
Practice Address - Street 1:202 S BENTLEY ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IL
Practice Address - Zip Code:62959-1908
Practice Address - Country:US
Practice Address - Phone:855-608-3560
Practice Address - Fax:618-997-6489
Is Sole Proprietor?:No
Enumeration Date:2009-05-19
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)