Provider Demographics
NPI:1770396517
Name:STEPHANIE HENDERSON, LCSW PLLC
Entity type:Organization
Organization Name:STEPHANIE HENDERSON, LCSW PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:HENDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:979-400-8918
Mailing Address - Street 1:12281 NEW WEHDEM RD
Mailing Address - Street 2:
Mailing Address - City:BRENHAM
Mailing Address - State:TX
Mailing Address - Zip Code:77833-7413
Mailing Address - Country:US
Mailing Address - Phone:979-400-8918
Mailing Address - Fax:
Practice Address - Street 1:12281 NEW WEHDEM RD
Practice Address - Street 2:
Practice Address - City:BRENHAM
Practice Address - State:TX
Practice Address - Zip Code:77833-7413
Practice Address - Country:US
Practice Address - Phone:979-400-8918
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STEPHANIE HENDERSON, LCSW PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-01-27
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty