Individual
DR. ALICIA YVETTE HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, PH.D.
Contact information
Practice address
160 W 86TH ST, NEW YORK, NY 10024-4018
(212) 362-5730
Mailing address
160 WEST 86TH STREET, NEW YORK, NY 10024
(212) 362-5730
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
R048309-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R048309-1
LICENSE NUMBER
NY
Enumeration date
11/11/2008
Last updated
11/18/2008
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