Provider Demographics
NPI:1245516806
Name:BARBARA K. HENRY LCSW, INC
Entity type:Organization
Organization Name:BARBARA K. HENRY LCSW, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:K
Authorized Official - Last Name:HENRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-898-5951
Mailing Address - Street 1:PO BOX 305
Mailing Address - Street 2:
Mailing Address - City:KIEL
Mailing Address - State:WI
Mailing Address - Zip Code:53042-0305
Mailing Address - Country:US
Mailing Address - Phone:920-894-7900
Mailing Address - Fax:920-894-7900
Practice Address - Street 1:317 FREMONT ST
Practice Address - Street 2:
Practice Address - City:KIEL
Practice Address - State:WI
Practice Address - Zip Code:53042-1423
Practice Address - Country:US
Practice Address - Phone:920-894-7900
Practice Address - Fax:920-894-7900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-27
Last Update Date:2011-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI506123251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health