Healthcare Provider Details

I. General information

NPI: 1437073046
Provider Name (Legal Business Name): MEKHI HENDERSON
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2602 NEBRASKA AVE
TOLEDO OH
43607-3241
US

IV. Provider business mailing address

2602 NEBRASKA AVE
TOLEDO OH
43607-3241
US

V. Phone/Fax

Practice location:
  • Phone: 419-318-9121
  • Fax:
Mailing address:
  • Phone: 419-318-9121
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: