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General NPI Number Information
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NPI Number | 1245516806
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Entity Type | Organization
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Legal Business Name | BARBARA K. HENRY LCSW, INC
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Dates
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Enumeration Date | 10/27/2011
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Last Update Date | 10/27/2011
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Provider Practice Location Address
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Address Line | 317 FREMONT ST
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City | KIEL
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State | WI
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Zip | 53042-1423
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Country | US
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Telephone | 920-894-7900
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Fax | 920-894-7900
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Provider Business Mailing Address
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Address Line | PO BOX 305
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City | KIEL
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State | WI
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Zip | 53042-0305
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Country | US
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Telephone | 920-894-7900
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Fax | 920-894-7900
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Authorized Official
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Title or Position | PRESIDENT
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Name | BARBARA K. HENRY
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Credential |
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Telephone | 920-898-5951
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 506123
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License Number State | WI
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