Provider Demographics
NPI:1255544250
Name:HENDERSON, NEELE MICHELLE (MS , LPC)
Entity type:Individual
Prefix:MRS
First Name:NEELE
Middle Name:MICHELLE
Last Name:HENDERSON
Suffix:
Gender:F
Credentials:MS , LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2044 HELMOKEN FALLS DR
Mailing Address - Street 2:
Mailing Address - City:ANNA
Mailing Address - State:TX
Mailing Address - Zip Code:75409-5120
Mailing Address - Country:US
Mailing Address - Phone:214-432-1759
Mailing Address - Fax:
Practice Address - Street 1:9555 LEBANON RD
Practice Address - Street 2:301
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-6080
Practice Address - Country:US
Practice Address - Phone:469-362-8044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18935101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional