Healthcare Provider Details

I. General information

NPI: 1104774512
Provider Name (Legal Business Name): LINDA HENSON LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

809 S PATTON RD
GREAT BEND KS
67530-4620
US

IV. Provider business mailing address

PO BOX 1223
GREAT BEND KS
67530-1223
US

V. Phone/Fax

Practice location:
  • Phone: 620-796-2206
  • Fax: 620-796-2208
Mailing address:
  • Phone: 620-796-2206
  • Fax: 620-796-2208

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number05264
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: