Provider Demographics
NPI:1467442434
Name:HENRY, JIMMY DANIEL (MSW, LCSW-S)
Entity type:Individual
Prefix:MR
First Name:JIMMY
Middle Name:DANIEL
Last Name:HENRY
Suffix:
Gender:M
Credentials:MSW, LCSW-S
Other - Prefix:
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Mailing Address - Street 1:18235 BULVERDE RD
Mailing Address - Street 2:SUITE 105, #36
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78259
Mailing Address - Country:US
Mailing Address - Phone:210-268-6125
Mailing Address - Fax:419-745-8425
Practice Address - Street 1:6029 CARRIAGE CPE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78261-2242
Practice Address - Country:US
Practice Address - Phone:210-268-6125
Practice Address - Fax:419-745-8425
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-21
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX305551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical