Provider Demographics
NPI:1609204486
Name:HENDLEY, PAUL DANIEL (LPC)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:DANIEL
Last Name:HENDLEY
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4440 LINDELL BLVD
Mailing Address - Street 2:UNIT #603
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63108-2449
Mailing Address - Country:US
Mailing Address - Phone:917-848-0365
Mailing Address - Fax:
Practice Address - Street 1:4440 LINDELL BLVD
Practice Address - Street 2:UNIT #603
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63108-2449
Practice Address - Country:US
Practice Address - Phone:917-848-0365
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-14
Last Update Date:2015-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013011418101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional