Provider Demographics
NPI:1013799147
Name:HENSLEY, THOMAS S (MA, AMFT)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:S
Last Name:HENSLEY
Suffix:
Gender:M
Credentials:MA, AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10200 SEPULVEDA BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:MISSION HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91345-3316
Mailing Address - Country:US
Mailing Address - Phone:323-879-9176
Mailing Address - Fax:818-484-4084
Practice Address - Street 1:5455 SYLMAR AVE APT 2303
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91401-5124
Practice Address - Country:US
Practice Address - Phone:323-974-1358
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-13
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA123380106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist