Provider Demographics
NPI:1730895426
Name:MCHENRY, LILLIAN PAULINE (MS)
Entity type:Individual
Prefix:
First Name:LILLIAN
Middle Name:PAULINE
Last Name:MCHENRY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:422 RICHVALE LN
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-2502
Mailing Address - Country:US
Mailing Address - Phone:832-977-6138
Mailing Address - Fax:888-651-1525
Practice Address - Street 1:422 RICHVALE LN
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-2502
Practice Address - Country:US
Practice Address - Phone:832-977-6138
Practice Address - Fax:888-651-1525
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-25
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX90849101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional