| Doctor Name: | COREY HENDERSON |
| NPI Number: | 1508212325 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC, NCC |
| License Number: | LPC 10514 |
| Business Practice Address: | 706 Northeast Dr Ste 1 Davidson, NC - 280367423 |
| Business Phone Number: | 9802752482 |
| Business Fax Number: | |
| Mailing Address: | 2732 N Davidson St, CHARLOTTE |
| State: | NC |
| Postal Code: | 282051043 |
| Phone Number: | 9802752482 |
| Fax Number: | |
| NPI Enumeration Date: | 05/11/2016 |
| NPI Last Update Date: | 05/11/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | LPC 10514 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |