Janis W Henderson

Individual provider Active NPI Mental Health Counselor · South Glastonbury, CT

NPI 1649487299 · NPPES record last updated Jul 16, 2007

Key facts

NPI
1649487299
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
001137 (CT)
Practice address
16 High St
South Glastonbury, CT 06033-9998
Phone
(860) 659-0183
NPI assigned
May 16, 2007
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
001137CTMDMental Health Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 001137 CT Yes

Addresses

Primary practice location

16 High St
South Glastonbury, CT 06033-9998

Mailing address

244 Wood Pond Rd
Glastonbury, CT 06033-3704
Phone (860) 633-6311

Other providers in South Glastonbury, CT

All providers in South Glastonbury, CT · Mental Health Counselor in Connecticut

Sources for this page

Verify at the official NPI Registry.