Herrick, Dale R

Herrick, Dale R is an individual health care provider with primary practice located at 3506 N Us Highway 51 , Janesville WI 53545-0726. He recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as his primary health care specialty. Herrick, Dale R can be contacted via phone (608) 757-5373.

Contact Information

Primary practice address
3506 N Us Highway 51 Janesville WI 53545-0726
Fax: (608) 758-8428
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 2028 123 Wisconsin

Profile Details

NPI number 1942338041
LBN Legal business name Herrick, Dale R
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 1st, 2007
Last updated Jul 9th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1942338041 NPPES
Wisconsin MEDICAID 39195400

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