Henderson, Latundra

Henderson, Latundra is an sole proprietor health care provider with primary practice located at 7232 Justin Way , Mentor OH 44060-4881. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Marriage & Family Therapist, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Henderson, Latundra can be contacted via phone (440) 578-8200.

Contact Information

Primary practice address
7232 Justin Way Mentor OH 44060-4881
Phone: (440) 578-8200
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X LICDC161330 Ohio
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X S1600147 Ohio
Behavioral Health & Social Service Providers / Clinical 1041C0700X I.2002418-SUPV Ohio

Profile Details

NPI number 1326599663
LBN Legal business name Henderson, Latundra
Credentials LISW, LICDC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 21st, 2016
Last updated Jan 28th, 2022 - about 4 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 1326599663 NPPES
Ohio MEDICAID 0423502

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