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Individual

JUDERIUS HENDERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCAS, LCSW-A

Contact information

Practice address
305 DOGTROT CT, FAYETTEVILLE, NC 28311-8932
(910) 987-0292
Mailing address
5500 S MIAMI BLVD APT 205, DURHAM, NC 27703-8288
(910) 987-0292

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCAS-25696
NC
1041C0700X
Clinical Social Worker
P013818
NC

Other

Enumeration date
08/10/2019
Last updated
04/20/2023
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