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NPI Code Detail

MEDICARE: MRS. ELLA WALKER HENDERSON M.A.P.C., LPC

MEDICARE: MRS. ELLA WALKER HENDERSON M.A.P.C., LPC
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
1101YP2500XProfessional Counselor5459SC

General Provider Information

NPI Number : 1811277593
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ELLA WALKER HENDERSON M.A.P.C., LPC
Provider Business Mailing Address
First Line : P.O. BOX 9371
Second Line :
City : GREENVILLE
State : SC
Zip : 29604
Country : US
Telephone Number : 864-660-9407
Fax Number :
Provider Business Practice Location Address
First Line : 7 PETTIGRU ST
Second Line :
City : GREENVILLE
State : SC
Zip : 29601-3028
Country : US
Telephone Number : 864-660-9407
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/25/2011
Last Update Date : 06/11/2014

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