Provider Demographics
NPI:1033125521
Name:BARNGROVER, SUSAN FARBER (PHD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:FARBER
Last Name:BARNGROVER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 SE DOUGLAS ST
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64063-4246
Mailing Address - Country:US
Mailing Address - Phone:816-524-5818
Mailing Address - Fax:816-524-5819
Practice Address - Street 1:409 SE DOUGLAS ST
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64063-4246
Practice Address - Country:US
Practice Address - Phone:816-524-5818
Practice Address - Fax:816-524-5819
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO01402103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
0003123AMedicare ID - Type Unspecified
R61668Medicare UPIN