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General NPI Number Information
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NPI Number | 1952645988
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Entity Type | Organization
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Legal Business Name | LINDSEY HENDERSON, PSYD, CLINICAL PSYCHOLOGIST, PLLC
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Dates
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Enumeration Date | 11/15/2012
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Last Update Date | 02/08/2013
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Provider Practice Location Address
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Address Line | 3820 HIGHWAY 5 N
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City | BRYANT
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State | AR
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Zip | 72022-9028
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Country | US
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Telephone | 501-323-0628
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2277
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City | BENTON
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State | AR
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Zip | 72018-2277
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Country | US
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Telephone | 501-323-0628
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Fax | 501-847-6160
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. LINDSEY MARIE HENDERSON
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Credential | PSYD
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Telephone | 501-232-0628
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 09-06P
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License Number State | AR
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