Individual provider Active NPI

Deborah A Hrdlicka, MA

  • Counselor
  • North Conway, NH
National Provider Identifier
1235223322
Registry record updated Sep 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
LCMHC203 Issued in NH
Practice address
170 Kearsarge Rd
North Conway, NH 03860-5331
Phone
(603) 356-4114
Fax
(603) 356-4118
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X LCMHC203 NH Primary

Addresses

Primary practice location

170 Kearsarge Rd
North Conway, NH 03860-5331

Mailing address

PO Box 503
North Conway, NH 03860-0503
Phone (603) 356-4114

Other identifiers 1

IdentifierTypeStateIssuer
30426632MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
LCMHC203NHMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
The Youth&Child Center for Wellness Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348185600000",
    "number": "1235223322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 503",
            "city": "NORTH CONWAY",
            "state": "NH",
            "postal_code": "038600503",
            "telephone_number": "603-356-4114",
            "fax_number": "603-356-4118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 KEARSARGE RD",
            "city": "NORTH CONWAY",
            "state": "NH",
            "postal_code": "038605331",
            "telephone_number": "603-356-4114",
            "fax_number": "603-356-4118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HRDLICKA",
        "first_name": "DEBORAH",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2012-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NH",
            "license": "LCMHC203",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30426632",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Conway, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.