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
Phone: (910) 791-6767
Fax: (910) 791-6890
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| 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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