Provider Demographics
NPI:1699498162
Name:HENDERSON, SHABRIAL (LCSW)
Entity type:Individual
Prefix:
First Name:SHABRIAL
Middle Name:
Last Name:HENDERSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11357 NUCKOLS RD # 1115
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23059-5504
Mailing Address - Country:US
Mailing Address - Phone:804-424-0230
Mailing Address - Fax:804-203-1665
Practice Address - Street 1:11357 NUCKOLS RD # 1115
Practice Address - Street 2:
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23059-5504
Practice Address - Country:US
Practice Address - Phone:804-424-0230
Practice Address - Fax:804-203-1665
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-20
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040143551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical