Provider Demographics
NPI:1336487313
Name:HENSHAW, ALTON TROY (MS, LPC)
Entity Type:Individual
Prefix:
First Name:ALTON
Middle Name:TROY
Last Name:HENSHAW
Suffix:
Gender:M
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 1:907 PORTER ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23224-2269
Mailing Address - Country:US
Mailing Address - Phone:804-393-4959
Mailing Address - Fax:
Practice Address - Street 1:907 PORTER ST
Practice Address - Street 2:APT. 1
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23224-2269
Practice Address - Country:US
Practice Address - Phone:804-393-4959
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-25
Last Update Date:2016-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701006455101YP2500X
101Y00000X, 101YA0400X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health