Provider Demographics
NPI:1043403678
Name:HAUCK, ANTHONY LAMBRICHTS (CACD II)
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:LAMBRICHTS
Last Name:HAUCK
Suffix:
Gender:M
Credentials:CACD II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1312 SW WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97205-2327
Mailing Address - Country:US
Mailing Address - Phone:503-535-1191
Mailing Address - Fax:503-535-1190
Practice Address - Street 1:1312 SW WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97205-2327
Practice Address - Country:US
Practice Address - Phone:503-535-1191
Practice Address - Fax:503-535-1190
Is Sole Proprietor?:No
Enumeration Date:2007-08-27
Last Update Date:2007-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor