| Doctor Name: | STEPHANIE A HENSON |
| NPI Number: | 1174962419 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSW, LCSW |
| License Number: | 149.015962 |
| Business Practice Address: | 820 Saint Louis Rd #232 Collinsville, IL - 622342024 |
| Business Phone Number: | 6182058209 |
| Business Fax Number: | 6183430428 |
| Mailing Address: | 50 Northgate Industrial Dr, GRANITE CITY |
| State: | IL |
| Postal Code: | 620406805 |
| Phone Number: | 6182058209 |
| Fax Number: | 6183430428 |
| NPI Enumeration Date: | 06/20/2013 |
| NPI Last Update Date: | 03/01/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 149.015962 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |