Provider Demographics
NPI:1831421874
Name:HENDERSON, LAMAR B (MSW, LICSW)
Entity type:Individual
Prefix:MR
First Name:LAMAR
Middle Name:B
Last Name:HENDERSON
Suffix:
Gender:M
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 75422
Mailing Address - Street 2:NATIONAL CAPITAL STATION
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20013-0422
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1200 G ST NW
Practice Address - Street 2:SUITE 800
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20005-3814
Practice Address - Country:US
Practice Address - Phone:202-434-8700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-01
Last Update Date:2010-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500783181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCLC50078318OtherHEALTH PROFESSIONAL LICENSING ADMINISTRATION BOARD OF SOCIAL WORK