Provider Demographics
NPI:1952691784
Name:HENDERSON, MARSHA (LMHC)
Entity Type:Individual
Prefix:MS
First Name:MARSHA
Middle Name:
Last Name:HENDERSON
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4902 EISENHOWER BLVD
Mailing Address - Street 2:SUITE 315
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33634-6310
Mailing Address - Country:US
Mailing Address - Phone:813-290-8560
Mailing Address - Fax:813-435-2033
Practice Address - Street 1:4902 EISENHOWER BLVD
Practice Address - Street 2:SUITE 315
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33634-6310
Practice Address - Country:US
Practice Address - Phone:813-290-8560
Practice Address - Fax:813-435-2033
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-13
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN101YM0800X
VA101YP2500X
SC101YP2500X
GA101YP2500X
FL101YP2500X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional