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NPI Code Detail

MEDICARE: ASHLEY HENDERSON

MEDICARE: ASHLEY HENDERSON
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1366373318
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEY HENDERSON
Provider Business Mailing Address
First Line : 18304 GRAND AVE
Second Line :
City : ELKHORN
State : NE
Zip : 68022-5321
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3803 N 153RD ST STE 200
Second Line :
City : OMAHA
State : NE
Zip : 68116-5176
Country : US
Telephone Number : 402-999-7713
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/28/2026
Last Update Date : 05/28/2026

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Directions to “ ASHLEY HENDERSON ” Practice Location

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