Provider Demographics
NPI:1558039057
Name:HENKHAUS, TRICIA RENEE (LCPC)
Entity Type:Individual
Prefix:MRS
First Name:TRICIA
Middle Name:RENEE
Last Name:HENKHAUS
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:316 N ALDRICH ST
Mailing Address - Street 2:
Mailing Address - City:GENESEO
Mailing Address - State:IL
Mailing Address - Zip Code:61254-2003
Mailing Address - Country:US
Mailing Address - Phone:309-212-2345
Mailing Address - Fax:
Practice Address - Street 1:316 N ALDRICH ST
Practice Address - Street 2:
Practice Address - City:GENESEO
Practice Address - State:IL
Practice Address - Zip Code:61254-2003
Practice Address - Country:US
Practice Address - Phone:309-502-1732
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-31
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional