Provider Demographics
NPI:1013182989
Name:HENRICKS, BARBARA DUGAN (LADC SAP MDIV)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:DUGAN
Last Name:HENRICKS
Suffix:
Gender:F
Credentials:LADC SAP MDIV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 FRONT ST STE 301
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:NH
Mailing Address - Zip Code:03833-2774
Mailing Address - Country:US
Mailing Address - Phone:603-583-5379
Mailing Address - Fax:603-658-1333
Practice Address - Street 1:24 FRONT ST STE 301
Practice Address - Street 2:
Practice Address - City:EXETER
Practice Address - State:NH
Practice Address - Zip Code:03833-2774
Practice Address - Country:US
Practice Address - Phone:603-583-5379
Practice Address - Fax:603-658-1333
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-23
Last Update Date:2016-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0493101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH1013182989OtherNPI