Provider Demographics
NPI:1942706072
Name:HENDERSON, CHRISTOPHER E
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:E
Last Name:HENDERSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:626 HERRIOTT RD
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:VT
Mailing Address - Zip Code:05663-6061
Mailing Address - Country:US
Mailing Address - Phone:802-522-2834
Mailing Address - Fax:
Practice Address - Street 1:626 HERRIOTT RD
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:VT
Practice Address - Zip Code:05663-6061
Practice Address - Country:US
Practice Address - Phone:802-522-2834
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-05
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health