Doctor Name: | MR. SAMUEL HENSLEY |
NPI Number: | 1376921320 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCAS |
License Number: | LCAS-3133 |
Business Practice Address: | 11 Pickens Ln Weaverville, NC - 287879321 |
Business Phone Number: | 8503809066 |
Business Fax Number: | |
Mailing Address: | 11 Pickens Ln, WEAVERVILLE |
State: | NC |
Postal Code: | 287879321 |
Phone Number: | 8503809066 |
Fax Number: | 8284848463 |
NPI Enumeration Date: | 05/11/2015 |
NPI Last Update Date: | 05/11/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | LCAS-3133 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |