Makenzie Henderson
Individual provider Active NPI Counseling Psychologist · Pittsburg, KS
NPI 1487465837 · NPPES record last updated Mar 31, 2025
Key facts
- NPI
- 1487465837
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counseling Psychologist 103TC1900X
- License
- 03380-T (KS)
- Practice address
- 911 E Centennial Dr
Pittsburg, KS 66762-6601 - Phone
- (620) 231-5130
- NPI assigned
- Jan 15, 2025
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03380-T | KS | MD | Counseling Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 03380-T | KS | Yes |
Addresses
Primary practice location
911 E Centennial Dr
Pittsburg, KS 66762-6601
Mailing address
313 S Hugh St
Frontenac, KS 66763-2203
Phone (620) 687-4266
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All providers in Pittsburg, KS · Counseling Psychologist in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 31, 2025. 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.