Individual provider · Type 1 NPI
Susan K. Henderson, LAC
Addiction (Substance Use Disorder) Counselor · South Bend, IN
NPI number
1225310402
Active
Practice location
403 E Madison St
South Bend, IN 46617-2322
Fax (574) 283-1131
Mailing address
PO Box 809
Goshen, IN 46527-0809
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | 86000033A (IN) |
Addiction (Substance Use Disorder) Counselor: Definition to come...
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About NPI 1225310402
Susan K. Henderson, LAC's National Provider Identifier is 1225310402, issued on Sep 14, 2011. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in South Bend, IN. The record was last updated on Sep 14, 2011.