Provider Demographics
NPI:1720441975
Name:HENDERSON, MEGAN ANN (LCPC)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:ANN
Last Name:HENDERSON
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3419 CENTRAL AVE STE A
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-6647
Mailing Address - Country:US
Mailing Address - Phone:406-672-8411
Mailing Address - Fax:406-272-1509
Practice Address - Street 1:3419 CENTRAL AVE STE A
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-6647
Practice Address - Country:US
Practice Address - Phone:406-672-8411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-04
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LCPC-LIC-16782101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT7090876Medicaid