Healthcare Provider Details

I. General information

NPI: 1649089608
Provider Name (Legal Business Name): STEPHANIE ANN HENDRICKS NCC,ATR-BC,LPC,LPAT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2025
Last Update Date: 01/04/2025
Certification Date: 01/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

57 HADDONFIELD RD STE 100
CHERRY HILL NJ
08002-4807
US

IV. Provider business mailing address

58B GRADY AVE
HAMILTON NJ
08610-4527
US

V. Phone/Fax

Practice location:
  • Phone: 609-889-8100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number37PC00949600
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number16LP00023800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: