Provider Demographics
NPI:1518571298
Name:DAVIS HENDERSON COUNSELING AND CONSULTING, LLC
Entity Type:Organization
Organization Name:DAVIS HENDERSON COUNSELING AND CONSULTING, LLC
Other - Org Name:NATOYA DAVIS HENDERSON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NATOYA
Authorized Official - Middle Name:DAVIS
Authorized Official - Last Name:HENDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:662-207-5820
Mailing Address - Street 1:609 SLIM ST
Mailing Address - Street 2:
Mailing Address - City:INDIANOLA
Mailing Address - State:MS
Mailing Address - Zip Code:38751-3551
Mailing Address - Country:US
Mailing Address - Phone:662-207-5820
Mailing Address - Fax:
Practice Address - Street 1:609 SLIM ST
Practice Address - Street 2:
Practice Address - City:INDIANOLA
Practice Address - State:MS
Practice Address - Zip Code:38751-3551
Practice Address - Country:US
Practice Address - Phone:662-207-5820
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-01
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health