| Anne A. Henderson, Inc. | |
|
115 N Cleveland Ave Brookhaven MS 39601-2713 | |
| (601) 835-3306 | |
| (601) 835-3342 |
| Full Name | Anne A. Henderson, Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 115 N Cleveland Ave, Brookhaven, Mississippi |
| Authorized Official Name and Position | Anne A Henderson (PRESIDENT) |
| Authorized Official Contact | 6018353306 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Anne A. Henderson, Inc. 311 Natchez Ave Brookhaven MS 39601-4055 Ph: (601) 835-5068 | Anne A. Henderson, Inc. 115 N Cleveland Ave Brookhaven MS 39601-2713 Ph: (601) 835-3306 |
| NPI Number | 1205044294 |
|---|---|
| Provider Enumeration Date | 05/21/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 9335247543 |
|---|---|
| Medicare Enrollment ID | O20070612000686 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205044294 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC1900X | Psychologist - Counseling | 30444 (Mississippi) | Primary |
| Provider Name | Anne A Henderson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1306877675 PECOS PAC ID: 2163520370 Enrollment ID: I20070612000679 |
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