Brandy Nichole Henderson, MA, PLPC

Individual provider Active NPI Professional Counselor · Florissant, MO

NPI 1346904562 · NPPES record last updated Mar 6, 2025

Key facts

NPI
1346904562
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
2021040533 (MO)
Practice address
2705 Mullanphy LN
Florissant, MO 63031-3727
Phone
(314) 830-6211
NPI assigned
Oct 25, 2021
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
2021040533MOMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X MO
Professional Counselor 101YP2500X 2021040533 MO Yes

Addresses

Primary practice location

2705 Mullanphy LN
Florissant, MO 63031-3727

Mailing address

1569 Norlakes Dr Apt C
Saint Louis, MO 63136-1849
Phone (314) 683-5730

Other providers in Florissant, MO

All providers in Florissant, MO · Professional Counselor in Missouri

Sources for this page

Verify at the official NPI Registry.