Provider Demographics
NPI:1972968048
Name:JUDITH R. DUCLAIR
Entity type:Organization
Organization Name:JUDITH R. DUCLAIR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:RANDY
Authorized Official - Last Name:DUCLAIR
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHC
Authorized Official - Phone:603-785-4420
Mailing Address - Street 1:1 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03064-6652
Mailing Address - Country:US
Mailing Address - Phone:603-883-0005
Mailing Address - Fax:
Practice Address - Street 1:1 MAIN STREET
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03064-6652
Practice Address - Country:US
Practice Address - Phone:603-883-0005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-16
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0940101YA0400X
NH1123101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty