Provider Demographics
NPI:1043535644
Name:HENLEY BERNARD, DIANA YEARBY (LPC)
Entity type:Individual
Prefix:MS
First Name:DIANA
Middle Name:YEARBY
Last Name:HENLEY BERNARD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1017 SAHALLEE DR
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-8270
Mailing Address - Country:US
Mailing Address - Phone:214-705-6753
Mailing Address - Fax:214-705-6153
Practice Address - Street 1:1017 SAHALLEE DR
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-8270
Practice Address - Country:US
Practice Address - Phone:214-705-6153
Practice Address - Fax:214-705-6153
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-07
Last Update Date:2010-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX130101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional