Doctor Name: | MRS. LAURA JANE HENCKLER |
NPI Number: | 1427183086 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | LC14040 |
Business Practice Address: | 453 Us Route 1 Kittery, ME - 039045513 |
Business Phone Number: | 2074511750 |
Business Fax Number: | 2074394360 |
Mailing Address: | 78 Atlantic Place, SOUTH PORTLAND |
State: | ME |
Postal Code: | 041062316 |
Phone Number: | 2078427701 |
Fax Number: | 2078427773 |
NPI Enumeration Date: | 02/23/2007 |
NPI Last Update Date: | 06/18/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | LC14040 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ME |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |