Provider Demographics
NPI:1144083940
Name:THE HENNICK GROUP, LLC
Entity type:Organization
Organization Name:THE HENNICK GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:HENNICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-723-5290
Mailing Address - Street 1:4902 CANAL ST STE 404
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-5874
Mailing Address - Country:US
Mailing Address - Phone:504-723-5290
Mailing Address - Fax:
Practice Address - Street 1:4902 CANAL ST STE 404
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-5874
Practice Address - Country:US
Practice Address - Phone:504-723-5290
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty