Provider Demographics
NPI:1942711080
Name:THE HENSON COUNSELING CENTER, LLC
Entity Type:Organization
Organization Name:THE HENSON COUNSELING CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:LANCE
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:HENSON
Authorized Official - Suffix:
Authorized Official - Credentials:LLC
Authorized Official - Phone:706-969-3569
Mailing Address - Street 1:335 MARGIE DR STE G
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-8908
Mailing Address - Country:US
Mailing Address - Phone:478-242-0210
Mailing Address - Fax:
Practice Address - Street 1:335 MARGIE DR STE G
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-8908
Practice Address - Country:US
Practice Address - Phone:478-242-0210
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-16
Last Update Date:2017-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC005156101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty