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NPI Code Detail

MEDICARE: MRS. AMANDA J HENDERSON MS, LCPC, LADC

MEDICARE:  MRS. AMANDA J HENDERSON  MS, LCPC, LADC
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
1101YA0400XAddiction (Substance Use Disorder) Counselor01421NV
2101YM0800XMental Health CounselorPC5752NV
3101YP2500XProfessional CounselorCP5752NV

General Provider Information

NPI Number : 1700226586
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. AMANDA J HENDERSON MS, LCPC, LADC
Provider Business Mailing Address
First Line : 323 N MARYLAND PKWY
Second Line :
City : LAS VEGAS
State : NV
Zip : 89101-3130
Country : US
Telephone Number : 702-385-3330
Fax Number :
Provider Business Practice Location Address
First Line : 323 N MARYLAND PKWY
Second Line :
City : LAS VEGAS
State : NV
Zip : 89101-3130
Country : US
Telephone Number : 702-385-3330
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/26/2013
Last Update Date : 09/27/2024

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Directions to “ MRS. AMANDA J HENDERSON MS, LCPC, LADC” Practice Location

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