Provider Demographics
NPI:1699527325
Name:HENDERSON, BRITTANY SHAR'NYCE (LPC, R-DMT)
Entity type:Individual
Prefix:MS
First Name:BRITTANY
Middle Name:SHAR'NYCE
Last Name:HENDERSON
Suffix:
Gender:F
Credentials:LPC, R-DMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5500 WISSAHICKON AVE APT 305B
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19144-5612
Mailing Address - Country:US
Mailing Address - Phone:214-708-1116
Mailing Address - Fax:
Practice Address - Street 1:5500 WISSAHICKON AVE APT 305B
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19144-5612
Practice Address - Country:US
Practice Address - Phone:214-708-1116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-04
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC016999101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional