Healthcare Provider Details

I. General information

NPI: 1376468470
Provider Name (Legal Business Name): JULIE M HENDERSON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 HODGES DR
EULESS TX
76040-5109
US

IV. Provider business mailing address

707 HODGES DR
EULESS TX
76040-5109
US

V. Phone/Fax

Practice location:
  • Phone: 682-344-9672
  • Fax:
Mailing address:
  • Phone: 682-344-9672
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number111182
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: