Individual ProviderDaniel HendersonSocial WorkerBehavioral Health & Social Service ProvidersPractice Address5965 S 900 E, Salt Lake City, UT 84121-1720(801) 263-7100(801) 596-0147PECOS EnrollmentBased on the most recent information from CMS, provider Daniel 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 2 days ago.Profile DetailsProvider ID1114361607Provider TypeIndividualFull NameHenderson, DanielCredentialLCSWGenderMaleSole ProprietorNoEnumeration Date4/26/2013Last Updated8/16/2023Contact InformationPractice LocationPractice Address5965 S 900 E, Salt Lake City, UT 84121-1720Phone(801) 263-7100FaxUnlisted FaxMailing LocationMailing Address5801 S Fashion Blvd Ste 250, Salt Lake City, UT 84107-6145Phone(801) 596-0147Fax(801) 716-4049Provider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense5933145-3501UtahCode390200000XDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer