Provider Demographics
NPI:1023717113
Name:HENDERSON, JASMINE (LPCA)
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:
Last Name:HENDERSON
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22442 HIGHFIELD RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77373-7846
Mailing Address - Country:US
Mailing Address - Phone:713-885-3588
Mailing Address - Fax:
Practice Address - Street 1:22442 HIGHFIELD RIDGE LN
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77373-7846
Practice Address - Country:US
Practice Address - Phone:713-885-3588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-27
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX88533101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional