Provider Demographics
NPI:1598382897
Name:HENAGE, LAKENDRA TAYLAINE (LPC)
Entity type:Individual
Prefix:
First Name:LAKENDRA
Middle Name:TAYLAINE
Last Name:HENAGE
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 1:11 N WATER ST STE 10290
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36602-5010
Mailing Address - Country:US
Mailing Address - Phone:251-209-2477
Mailing Address - Fax:251-219-9664
Practice Address - Street 1:11 N WATER ST STE 10290
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36602-5010
Practice Address - Country:US
Practice Address - Phone:251-209-2477
Practice Address - Fax:251-219-9664
Is Sole Proprietor?:No
Enumeration Date:2020-07-02
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC01499101YP2500X
FLTPMC474101YP2500X
SCTLC1512PC101YP2500X
AL4295101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional