Healthcare Provider Details

I. General information

NPI: 1982302279
Provider Name (Legal Business Name): TODD JOSEPH HENDRIX LPC, NCC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/16/2023
Last Update Date: 09/09/2025
Certification Date: 09/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

353 HIGHWAY 15 N
PONTOTOC MS
38863-1103
US

IV. Provider business mailing address

PO BOX 497
AUGUSTA AR
72006-0497
US

V. Phone/Fax

Practice location:
  • Phone: 662-490-1985
  • Fax: 662-490-1989
Mailing address:
  • Phone: 870-347-2534
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2904
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: