Provider Demographics
NPI:1033512751
Name:PROBST, BARRY (MFT, CSAC)
Entity Type:Individual
Prefix:MR
First Name:BARRY
Middle Name:
Last Name:PROBST
Suffix:
Gender:M
Credentials:MFT, CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:284 FRONT ST
Mailing Address - Street 2:
Mailing Address - City:LAHAINA
Mailing Address - State:HI
Mailing Address - Zip Code:96761-1112
Mailing Address - Country:US
Mailing Address - Phone:808-205-0374
Mailing Address - Fax:
Practice Address - Street 1:284 FRONT ST
Practice Address - Street 2:
Practice Address - City:LAHAINA
Practice Address - State:HI
Practice Address - Zip Code:96761-1112
Practice Address - Country:US
Practice Address - Phone:808-205-0374
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-08
Last Update Date:2017-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI499106H00000X
HI1675-12101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)