Individual ProviderLawrence HendersonCounselorBehavioral Health & Social Service ProvidersPractice Address1201 N El Dorado St, Stockton, CA 95202-1306(209) 468-3760(209) 468-8700PECOS EnrollmentBased on the most recent information from CMS, provider Lawrence Henderson does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1457701344Provider TypeIndividualFull NameHenderson, LawrenceGenderMaleSole ProprietorNoEnumeration Date6/21/2016Last Updated6/21/2016Contact InformationPractice LocationPractice Address1201 N El Dorado St, Stockton, CA 95202-1306Phone(209) 468-3760FaxUnlisted FaxMailing LocationMailing Address1212 N California St, Stockton, CA 95202-1552Phone(209) 468-8700FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer