Provider Demographics
NPI:1487463865
Name:HENDRICKSON, JEANIE LYNN (LPC)
Entity type:Individual
Prefix:
First Name:JEANIE
Middle Name:LYNN
Last Name:HENDRICKSON
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 1:10815 ROYAL PINE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77093-3522
Mailing Address - Country:US
Mailing Address - Phone:561-577-6061
Mailing Address - Fax:
Practice Address - Street 1:10815 ROYAL PINE DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77093-3522
Practice Address - Country:US
Practice Address - Phone:561-577-6061
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-31
Last Update Date:2024-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX91783101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional