Individual
JEAN MARIE HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCMHC
Contact information
Practice address
100 LEDGEHILL RD, BENNINGTON, VT 05201-2273
(802) 442-5491
(802) 442-4910
Mailing address
100 LEDGEHILL RD, BENNINGTON, VT 05201-2273
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
068-0000538
VT
101YA0400X
Addiction (Substance Use Disorder) Counselor
068-0000538
VT
101YM0800X
Mental Health Counselor
Primary
068-0000538
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1010781
—
VT
01
—
2276538
CIGNA
VT
01
—
68191
BLUE CROSS
—
Enumeration date
08/05/2006
Last updated
10/02/2015
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