PHAEDRA HENDERSON NPI 1770952772

NPI Information

NPI: 1770952772
Provider Name: PHAEDRA HENDERSON
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
32 S MACDONALD
MESA, AZ
ZIP 85210
Phone: (480) 969-1471
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Phaedra Henderson is an addiction (substance use disorder) counselor in Mesa, AZ. Phaedra Henderson NPI is 1770952772. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

32 S MACDONALD
MESA, AZ
ZIP 85210-310
Phone: (480) 969-1471
Fax: (480) 269-9426

The enumeration date for this NPI number is 9/19/2015 and was last updated on 9/19/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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