Provider Demographics
NPI:1184285694
Name:HENDERSON, SHERIDAN KATHERINE (LMFT)
Entity type:Individual
Prefix:
First Name:SHERIDAN
Middle Name:KATHERINE
Last Name:HENDERSON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 S BEVERLY DR STE 212
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-4805
Mailing Address - Country:US
Mailing Address - Phone:310-752-1157
Mailing Address - Fax:310-861-0459
Practice Address - Street 1:300 S BEVERLY DR
Practice Address - Street 2:STE 212
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212
Practice Address - Country:US
Practice Address - Phone:310-752-1157
Practice Address - Fax:310-861-0459
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-25
Last Update Date:2024-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA113855106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist