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NPI Code Detail

MEDICARE: KRISTEN HENDERSON LICSW

MEDICARE: KRISTEN HENDERSON LICSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerLW.61659905WA

General Provider Information

NPI Number : 1043152242
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTEN HENDERSON LICSW
Provider Business Mailing Address
First Line : 711 STATE AVE NE
Second Line :
City : OLYMPIA
State : WA
Zip : 98506-3984
Country : US
Telephone Number : 360-943-0780
Fax Number :
Provider Business Practice Location Address
First Line : 711 STATE AVE NE
Second Line :
City : OLYMPIA
State : WA
Zip : 98506-3984
Country : US
Telephone Number : 360-943-0780
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/07/2026
Last Update Date : 04/07/2026

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Directions to “ KRISTEN HENDERSON LICSW” Practice Location

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