Tanya Henderson, LCSW-C
Individual provider Active NPI Clinical Social Worker · Poolesville, MD
NPI 1295297166 · NPPES record last updated Dec 24, 2024
Key facts
- NPI
- 1295297166
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 24194 (MD)
- Practice address
- 14804 Sugarland Rd
Poolesville, MD 20837-8928 - Phone
- (240) 750-0724
- NPI assigned
- Apr 1, 2019
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 24194 | MD | Yes |
Addresses
Primary practice location
14804 Sugarland Rd
Poolesville, MD 20837-8928
Mailing address
14804 Sugarland Rd
Poolesville, MD 20837-8928
Phone (240) 750-0724
Other providers in Poolesville, MD
- Amar Venkat Duggirala
- Nicole Eve Fayard
- Victoria Fayard
- Gregory Mark Glenn
- Maria Christina Hancu
- Patricia Kapsiak Hess
- Holistic Family Medicine
- Maureen D Ivusic
- Nicole Kayo
- Sang Kim
All providers in Poolesville, MD · Clinical Social Worker in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 24, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.