Henderson, Russell Lee
Henderson, Russell Lee is an individual health care provider with primary practice located at 175 Emery Hwy , Macon GA 31217-3692. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Henderson, Russell Lee can be contacted via phone (478) 751-4446.Contact Information
Primary practice address
175 Emery Hwy
Macon GA 31217-3692
Phone: (478) 751-4446
Fax: (478) 751-4444
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | CSW001731 | Georgia |
Profile Details
| NPI number | 1538366000 |
|---|---|
| LBN Legal business name | Henderson, Russell Lee |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 28th, 2007 |
| Last updated | Jul 8th, 2007 - about 18 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 | 1538366000 | NPPES |
| Georgia | Other | CSW001731 | LCSW |
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