MEDICARE: MRS. JENAH C HENDERSON M.A. LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	LMFT95737	CA

General Provider Information

NPI Number	:	1144569161
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JENAH C HENDERSON M.A. LMFT

Provider Business Mailing Address
First Line	:	114 E HALEY ST STE E
Second Line	:
City	:	SANTA BARBARA
State	:	CA
Zip	:	93101-2347
Country	:	US
Telephone Number	:	805-705-2784
Fax Number	:

Provider Business Practice Location Address
First Line	:	114 E HALEY ST STE E
Second Line	:
City	:	SANTA BARBARA
State	:	CA
Zip	:	93101-2347
Country	:	US
Telephone Number	:	805-705-2784
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/12/2013
Last Update Date	:	10/04/2019

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