Provider Demographics
NPI:1548968845
Name:HENDRSON, SHANNON JENEE
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:JENEE
Last Name:HENDRSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 S DUNTON AVE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-1904
Mailing Address - Country:US
Mailing Address - Phone:847-502-3445
Mailing Address - Fax:
Practice Address - Street 1:212 S DUNTON AVE
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-1904
Practice Address - Country:US
Practice Address - Phone:847-502-3445
Practice Address - Fax:847-258-3120
Is Sole Proprietor?:No
Enumeration Date:2023-02-16
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor