Provider Demographics
NPI:1881983559
Name:HENDERSON, ERLINDA LATONYA (MSW, LBSW)
Entity type:Individual
Prefix:
First Name:ERLINDA
Middle Name:LATONYA
Last Name:HENDERSON
Suffix:
Gender:F
Credentials:MSW, LBSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 NEW MARKET DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29073-8756
Mailing Address - Country:US
Mailing Address - Phone:803-466-4102
Mailing Address - Fax:
Practice Address - Street 1:132 NEW MARKET DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29073-8756
Practice Address - Country:US
Practice Address - Phone:803-466-4102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-04
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8530104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker