Provider Demographics
NPI:1902058134
Name:HENDERSON, YALANDA GRIFFIN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:YALANDA
Middle Name:GRIFFIN
Last Name:HENDERSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:YALANDA
Other - Middle Name:MARIE
Other - Last Name:GRIFFIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1212 QUINCY DR
Mailing Address - Street 2:
Mailing Address - City:GLENN HEIGHTS
Mailing Address - State:TX
Mailing Address - Zip Code:75154-8699
Mailing Address - Country:US
Mailing Address - Phone:972-533-1572
Mailing Address - Fax:972-533-1572
Practice Address - Street 1:407 N CEDAR RIDGE DR
Practice Address - Street 2:STE 227
Practice Address - City:DUNCANVILLE
Practice Address - State:TX
Practice Address - Zip Code:75116-3169
Practice Address - Country:US
Practice Address - Phone:972-502-4020
Practice Address - Fax:214-330-4671
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-21
Last Update Date:2019-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX368901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical