Doctor Name: | MS. CAROLYN J. HENDERSON |
NPI Number: | 1316015647 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | L.I.C.S.W. |
License Number: | 3253 |
Business Practice Address: | 1 Minni Tohe Dr Minne Tohe Health Center New Town, ND - 587634400 |
Business Phone Number: | 7016274701 |
Business Fax Number: | 7016272810 |
Mailing Address: | 1 Minni Tohe Dr, Minne Tohe Health Center NEW TOWN |
State: | ND |
Postal Code: | 587634400 |
Phone Number: | 7016274701 |
Fax Number: | 7016272810 |
NPI Enumeration Date: | 12/04/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 3253 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ND |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |