Provider Demographics
NPI:1558516898
Name:HENRY, BRIANA NICOLE (LMFT)
Entity type:Individual
Prefix:
First Name:BRIANA
Middle Name:NICOLE
Last Name:HENRY
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 1:26293 CARNEGIE AVE
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92544-6413
Mailing Address - Country:US
Mailing Address - Phone:951-203-3697
Mailing Address - Fax:
Practice Address - Street 1:26293 CARNEGIE AVE
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92544-6413
Practice Address - Country:US
Practice Address - Phone:951-203-3697
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-01
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA104847106H00000X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist