Provider Demographics
NPI:1841839990
Name:HENDERSON, LEAH CHRISTINE (LPC-MHSP)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:CHRISTINE
Last Name:HENDERSON
Suffix:
Gender:F
Credentials:LPC-MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 SPADE LEAF BLVD APT 621
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-3797
Mailing Address - Country:US
Mailing Address - Phone:404-313-1198
Mailing Address - Fax:
Practice Address - Street 1:115 HAZEL PATH STE 2
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-3817
Practice Address - Country:US
Practice Address - Phone:404-313-1198
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-06
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health