Provider Demographics
NPI:1053321166
Name:WOODARD HYPNOSIS AND RESEARCH, INC.
Entity Type:Organization
Organization Name:WOODARD HYPNOSIS AND RESEARCH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FREDRICK
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:WOODARD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:603-673-2582
Mailing Address - Street 1:PO BOX 874
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03055-0874
Mailing Address - Country:US
Mailing Address - Phone:603-673-2582
Mailing Address - Fax:
Practice Address - Street 1:15B LINCOLN STREET
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:NH
Practice Address - Zip Code:03055
Practice Address - Country:US
Practice Address - Phone:603-673-2582
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2013-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1082103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3073391Medicaid
NH3073391Medicaid
NHWO-RE8378Medicare ID - Type UnspecifiedINDIVIDUAL