| Doctor Name: | MR. HAROLD JORDAN HENDERSON |
| NPI Number: | 1083761241 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LPC |
| License Number: | 122 |
| Business Practice Address: | 1075 Check St Suite 101 Wasilla, AK - 996548047 |
| Business Phone Number: | 9073571629 |
| Business Fax Number: | 9073571639 |
| Mailing Address: | 1075 Check St, Suite 101 WASILLA |
| State: | AK |
| Postal Code: | 996548047 |
| Phone Number: | 9073571629 |
| Fax Number: | 9073571639 |
| NPI Enumeration Date: | 01/03/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 122 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AK |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |