Chasity Henson

Individual provider Active NPI School Counselor · Portland, TN

NPI 1457719213 · NPPES record last updated Feb 8, 2016

Key facts

NPI
1457719213
Entity type
Individual (NPI type 1)
Primary specialty
School Counselor 101YS0200X
License
201184421 (KY)
Practice address
1098 Gateview Dr
Portland, TN 37148-2166
Phone
(270) 705-5892
NPI assigned
Feb 8, 2016
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

State licenses

LicenseStateTypeSpecialty
201184421KYMDSchool Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
School Counselor 101YS0200X 201184421 KY Yes

Addresses

Primary practice location

1098 Gateview Dr
Portland, TN 37148-2166

Mailing address

2722 Utah Dr
Bowling Green, KY 42104-4306
Phone (270) 705-5892

Other providers in Portland, TN

All providers in Portland, TN · School Counselor in Tennessee

Sources for this page

Verify at the official NPI Registry.