Individual
MR. CARLTON KEITH HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1384 MADISON AVENUE, MEMPHIS, TN 38104
(901) 493-1103
(901) 726-4281
Mailing address
1384 MADISON AVE, MEMPHIS, TN 38104-2327
(901) 493-1103
(901) 726-4281
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
TN-048
TN
1041C0700X
Clinical Social Worker
1939-C
AR
1041C0700X
Clinical Social Worker
Primary
3661
TN
Other
Enumeration date
11/03/2006
Last updated
02/22/2023
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