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NPI Code Detail

MEDICARE: DR. ERIN N HENDERSON PHD

MEDICARE:  DR. ERIN N HENDERSON  PHD
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
1103TC0700XClinical PsychologistPS015659PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1101494070 0001OTHERPAPROMISE MA NUMBER
21782310OTHERPAHIGHMARK PROVIDER #

General Provider Information

NPI Number : 1780646968
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ERIN N HENDERSON PHD
Provider Business Mailing Address
First Line : 3439 THORNWOOD DR
Second Line :
City : BETHEL PARK
State : PA
Zip : 15102-1462
Country : US
Telephone Number : 412-851-4102
Fax Number : 206-333-1054
Provider Business Practice Location Address
First Line : 71 MCMURRAY RD
Second Line : SUITE 112
City : PITTSBURGH
State : PA
Zip : 15241-1634
Country : US
Telephone Number : 412-568-1250
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/04/2006
Last Update Date : 10/24/2012

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