Healthcare Provider Details

I. General information

NPI: 1710511217
Provider Name (Legal Business Name): HENDERSON COUNSELING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2020
Last Update Date: 02/24/2020
Certification Date: 02/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 E HORIZON DR STE 100
HENDERSON NV
89015-7933
US

IV. Provider business mailing address

PO BOX 778413
HENDERSON NV
89077-8413
US

V. Phone/Fax

Practice location:
  • Phone: 702-886-0988
  • Fax: 702-947-5352
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MS. CATHY CASSIDY
Title or Position: PRESIDENT
Credential:
Phone: 702-886-0988