Provider Demographics
NPI:1740381466
Name:HENDERSON, LINDSEY (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LINDSEY
Middle Name:
Last Name:HENDERSON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2277
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:AR
Mailing Address - Zip Code:72018-2277
Mailing Address - Country:US
Mailing Address - Phone:501-232-0628
Mailing Address - Fax:501-847-6160
Practice Address - Street 1:3820 HIGHWAY 5 N
Practice Address - Street 2:
Practice Address - City:BRYANT
Practice Address - State:AR
Practice Address - Zip Code:72022-9028
Practice Address - Country:US
Practice Address - Phone:501-232-0628
Practice Address - Fax:501-847-6160
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR09-06P103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5V1666979Medicare PIN