Individual
GENEVIEVE HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1455 DIXON AVE, LAFAYETTE, CO 80026-8879
(303) 443-8500
Mailing address
3454 W MONCRIEFF PL, DENVER, CO 80211-3162
(904) 228-7677
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
CO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1407545825
—
CO
Enumeration date
05/02/2023
Last updated
09/03/2023
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