Henderson, Diane

Henderson, Diane is an individual health care provider with primary practice located at 311 Judges Rd 4E, Wilmington NC 28405-3651. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Henderson, Diane can be contacted via phone (910) 791-6767.

Contact Information

Primary practice address
311 Judges Rd 4E Wilmington NC 28405-3651
Fax: (910) 791-6890
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X C001733 North Carolina

Profile Details

NPI number 1225020696
LBN Legal business name Henderson, Diane
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 22nd, 2005
Last updated Jan 23rd, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225020696 NPPES
North Carolina Other 40981 BCBS NC
North Carolina Other 62-00248 BCBS NC
North Carolina MEDICAID 6003386 BCBS NC

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