Provider Demographics
NPI:1780646968
Name:HENDERSON, ERIN N (PHD)
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:N
Last Name:HENDERSON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3439 THORNWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BETHEL PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15102-1462
Mailing Address - Country:US
Mailing Address - Phone:412-851-4102
Mailing Address - Fax:206-333-1054
Practice Address - Street 1:71 MCMURRAY RD
Practice Address - Street 2:SUITE 112
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15241-1634
Practice Address - Country:US
Practice Address - Phone:412-568-1250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-04
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS015659103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101494070 0001OtherPROMISE MA NUMBER
PA1782310OtherHIGHMARK PROVIDER #