1790291466 NPI number — MS. YVONNE BARNES LGPC

Table of content: MS. YVONNE BARNES LGPC (NPI 1790291466)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790291466 NPI number — MS. YVONNE BARNES LGPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BARNES
Provider First Name:
YVONNE
Provider Middle Name:
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LGPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BARNES
Provider Other First Name:
YVONNE
Provider Other Middle Name:
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1790291466
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/18/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8903 STONE CREEK PLACE, UNIT #202
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PIKESVILLE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21208
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
443-983-8580
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1407 LOCHNER RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21239-2932
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
443-402-3200
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/18/2017

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  LGP7335 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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