Rodney Henderson | Los Angeles, CA • PECOS Search

Rodney Henderson

Counselor

Behavioral Health & Social Service Providers

5320 S Broadway, Los Angeles, CA 90037-3808

PECOS Enrollment

Based on the most recent information from CMS, provider Rodney Henderson does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records today at 9:43 AM.

Profile Details

Provider ID
1093443400
Provider Type
Individual
Full Name
Henderson, Rodney
Credential
SUDCC 8482

Gender
Male
Sole Proprietor
Yes
Enumeration Date
8/12/2022
Last Updated
8/12/2022

Contact Information

Practice Location

5320 S Broadway, Los Angeles, CA 90037-3808

Unlisted Fax

Mailing Location

5320 S Broadway, Los Angeles, CA 90037-3808

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 101YA0400X Primary	Description Counselor Behavioral Health & Social Service Providers	License SUDCC8482 California