Provider Demographics
NPI:1225129208
Name:LODDENGAARD, NANCY ELLEN (LICSW)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:ELLEN
Last Name:LODDENGAARD
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 ELM STREET
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03055
Mailing Address - Country:US
Mailing Address - Phone:603-672-5005
Mailing Address - Fax:603-672-6501
Practice Address - Street 1:16 ELM STREET
Practice Address - Street 2:FAMILY GUIDANCE CENTER OF MILFORD
Practice Address - City:MILFORD
Practice Address - State:NH
Practice Address - Zip Code:03055
Practice Address - Country:US
Practice Address - Phone:603-672-5005
Practice Address - Fax:603-672-6501
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1004104100000X
MA105900104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker