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General NPI Number Information
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NPI Number | 1407016272
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Entity Type | Individual
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Provider Name | STEPHANIE S HENRY LCSW, CAP
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Gender | Female
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Dates
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Enumeration Date | 06/14/2008
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Last Update Date | 10/22/2010
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Provider Practice Location Address
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Address Line | 8358 W. OAKLAND PARK BLVD. SUITE 202K
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City | SUNRISE
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State | FL
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Zip | 33351
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Country | US
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Telephone | 954-298-7859
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Fax |
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Provider Business Mailing Address
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Address Line | 8358 W. OAKLAND PARK BLVD. SUITE 202K
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City | SUNRISE
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State | FL
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Zip | 33351
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Country | US
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Telephone | 954-298-7859
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CAP 4220
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW9001
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License Number State | FL
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