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Individual

CAROLINE HENDERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
110 LAKESIDE CT, STATESBORO, GA 30458-9122
(912) 536-6144
Mailing address
110 LAKESIDE CT, STATESBORO, GA 30458-9122
(912) 536-6144

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW008187
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
CSW008187
LCSW
GA
Enumeration date
08/04/2022
Last updated
07/23/2025
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