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NPI Code Detail

MEDICARE: REBECCA LEAH HENDERSON LMFT

MEDICARE: REBECCA LEAH HENDERSON LMFT
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
1106H00000XMarriage & Family TherapistMT3630FL
2106H00000XMarriage & Family TherapistMFT001263GA
3106H00000XMarriage & Family Therapist0717001752VA
4106H00000XMarriage & Family Therapist10290NC

General Provider Information

NPI Number : 1497224927
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA LEAH HENDERSON LMFT
Provider Business Mailing Address
First Line : 10710 MIDLOTHIAN TPKE STE 127
Second Line :
City : NORTH CHESTERFIELD
State : VA
Zip : 23235-4776
Country : US
Telephone Number : 804-280-0832
Fax Number :
Provider Business Practice Location Address
First Line : 10710 MIDLOTHIAN TPKE STE 127
Second Line :
City : NORTH CHESTERFIELD
State : VA
Zip : 23235-4776
Country : US
Telephone Number : 804-280-0832
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/14/2018
Last Update Date : 04/24/2024

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