Provider Demographics
NPI:1841344496
Name:HENDERSON, PATRICIA L (MA LMHC)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:L
Last Name:HENDERSON
Suffix:
Gender:F
Credentials:MA LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1210 10TH ST STE 203
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-7063
Mailing Address - Country:US
Mailing Address - Phone:360-676-1513
Mailing Address - Fax:360-647-1043
Practice Address - Street 1:1210 10TH ST STE 203
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-7063
Practice Address - Country:US
Practice Address - Phone:360-676-1513
Practice Address - Fax:360-647-1043
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00005898101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health