Individual
STACEY HENDRICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
817 W WALNUT ST STE 12, JOHNSON CITY, TN 37604-6144
(423) 218-9394
Mailing address
918 ALTHEA ST, JOHNSON CITY, TN 37601-2120
(423) 218-9394
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
9383
TN
Other
Enumeration date
11/10/2025
Last updated
11/10/2025
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