Provider Information for 1821374463
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DONALD KIRK HENDERSON M.A.
Other Names:Other Name:Mr. KIRK D HENDERSON LPC-MHSPSex: Male
NPI: 1821374463
Last Updated: 2024-12-11
Certification Date: 2024-12-11
Certification Date: 2024-12-11
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1821374463 | ||||||||||||
| Enumeration Date | 2011-10-27 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 100 N HOWARD ST SPOKANE, WA 99201-0508 United States Phone: 615-854-5693 | Fax: | ||||||||||||
| Primary Practice Address | 7003 CHADWICK DR STE 133 BRENTWOOD, TN 37027-5288 United States Phone: 615-854-5693 | Fax: | ||||||||||||
| Secondary Practice Address(es) | 100 N HOWARD ST | ||||||||||||
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