Provider Demographics
NPI:1265527568
Name:HENRICHS, URSULA I (LICSW)
Entity type:Individual
Prefix:MRS
First Name:URSULA
Middle Name:I
Last Name:HENRICHS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:URSULA
Other - Middle Name:I
Other - Last Name:SCHAADT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:175 JASON STREET
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02476-8033
Mailing Address - Country:US
Mailing Address - Phone:617-628-5070
Mailing Address - Fax:
Practice Address - Street 1:NOVA PSYCHIATRIC SERVICES, PC
Practice Address - Street 2:1261 FURNACE BROOK PARKWAY SUITE 31
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169
Practice Address - Country:US
Practice Address - Phone:617-479-4545
Practice Address - Fax:617-479-4555
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
MA1022830104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker