Provider Demographics
NPI:1346086527
Name:HENRICKS, COLETTE CLARE (LPC)
Entity type:Individual
Prefix:
First Name:COLETTE
Middle Name:CLARE
Last Name:HENRICKS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7708 FOREST WOOD RD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-6224
Mailing Address - Country:US
Mailing Address - Phone:512-470-6727
Mailing Address - Fax:
Practice Address - Street 1:7708 FOREST WOOD RD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-6224
Practice Address - Country:US
Practice Address - Phone:512-470-6727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-08
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX83728101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health