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
Phone: (608) 757-5373
Fax: (608) 758-8428
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1942338041 | NPPES |
| Wisconsin | MEDICAID | 39195400 |
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