Dr. Davetta A Henderson, PsyD, LMHC
Counselor, Mental Health in Fort Worth, TX. Individual provider (NPI-1).
NPI number1164069829
StatusActive
Last updated in NPPESMar 22, 2024
Details
- NPI
- 1164069829
- Entity type
- Individual (NPI-1)
- Name
- Dr. Davetta A Henderson
- Credential
- PsyD, LMHC
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Dec 2, 2019
- Certification date
- Mar 22, 2024
- Last updated
- Mar 22, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | 91192 | TX | Yes |
| 101YM0800X | Counselor, Mental Health | 39003653A | IN |
Other names
- Davetta A Carlisle (Former Name)
Practice location
4115 E Lancaster AveFort Worth, TX 76103-3614
Phone 817-796-7370
Mailing address
1800 N Meridian St Ste 505Indianapolis, IN 46202-1433
Phone 317-464-3515
Other practice locations
1800 N Meridian St Ste 505
Indianapolis, IN 46202-1433
Indianapolis, IN 46202-1433
Phone 317-464-3515
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