Provider Demographics
NPI:1215089719
Name:HENRY, LINDSAY ERIN
Entity type:Individual
Prefix:MRS
First Name:LINDSAY
Middle Name:ERIN
Last Name:HENRY
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:LINDSAY
Other - Middle Name:ERIN
Other - Last Name:HENRY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:300 HARDING AVE
Mailing Address - Street 2:ROSEVILLE, CA 95678
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95833-2560
Mailing Address - Country:US
Mailing Address - Phone:916-740-0410
Mailing Address - Fax:916-609-5100
Practice Address - Street 1:300 HARDING BLVD
Practice Address - Street 2:ROSEVILLE, CA 95678
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95678-2470
Practice Address - Country:US
Practice Address - Phone:916-740-0410
Practice Address - Fax:916-609-5100
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 236931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical