Provider Demographics
NPI:1760527451
Name:HENDERSON, MOLLY MARIE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:MOLLY
Middle Name:MARIE
Last Name:HENDERSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1456 MCKINLEY ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97402-3341
Mailing Address - Country:US
Mailing Address - Phone:541-729-3134
Mailing Address - Fax:
Practice Address - Street 1:1456 MCKINLEY ST
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97402-3341
Practice Address - Country:US
Practice Address - Phone:541-729-3134
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health