Individual
BARRY DEXTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSAC
Contact information
Practice address
1100 LAKE VIEW DR, WAUSAU, WI 54403-6785
(715) 848-4600
(715) 845-5398
Mailing address
1100 LAKE VIEW DR, WAUSAU, WI 54403-6785
(715) 848-4600
(715) 845-5398
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
2087
WI
104100000X
Social Worker
1583-120
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1583-120
STATE LICENSE
WI
01
—
2087-132
STATE LICENSE
WI
Enumeration date
08/11/2006
Last updated
04/15/2013
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