Individual
TANYA HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CMHT
Contact information
Practice address
3450 HIGHWAY 80 W, JACKSON, MS 39209-7201
(601) 321-2400
Mailing address
6225 WOODSTOCK DR, JACKSON, MS 39206-2329
(601) 321-2400
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00018209
—
MS
Enumeration date
04/16/2026
Last updated
04/16/2026
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