| Jeff Henderson Phd Psychological Services And Consulting Pc | |
|
1680 W Iron Springs Rd Suite 102 Prescott AZ 86305-3313 | |
| (928) 458-6634 | |
| (928) 445-2919 |
| Full Name | Jeff Henderson Phd Psychological Services And Consulting Pc |
|---|---|
| Speciality | Psychologist |
| Location | 1680 W Iron Springs Rd, Prescott, Arizona |
| Authorized Official Name and Position | Jeffery Paul Henderson (PRESIDENT PSYCHOLOGIST) |
| Authorized Official Contact | 9284586634 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jeff Henderson Phd Psychological Services And Consulting Pc 7929 E Sleepy Owl Way Prescott Valley AZ 86315-3023 Ph: (928) 458-6634 | Jeff Henderson Phd Psychological Services And Consulting Pc 1680 W Iron Springs Rd Suite 102 Prescott AZ 86305-3313 Ph: (928) 458-6634 |
| NPI Number | 1255413118 |
|---|---|
| Provider Enumeration Date | 10/19/2006 |
| Last Update Date | 09/15/2009 |
| Medicare PECOS PAC ID | 0345266268 |
|---|---|
| Medicare Enrollment ID | O20100107000669 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255413118 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC1900X | Psychologist - Counseling | 4041 (Arizona) | Primary |
| Provider Name | Jeffery P Henderson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1508964784 PECOS PAC ID: 7416917448 Enrollment ID: I20100107000626 |
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