Provider Demographics
NPI:1104849983
Name:BARTON-SCHERDER, ANGELA ROSE (LPC)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:ROSE
Last Name:BARTON-SCHERDER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:
Other - Last Name:BARTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:818 W CHAMP CLARK DR
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:MO
Mailing Address - Zip Code:63334-2034
Mailing Address - Country:US
Mailing Address - Phone:573-324-5655
Mailing Address - Fax:573-324-5490
Practice Address - Street 1:818 W CHAMP CLARK DR
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:MO
Practice Address - Zip Code:63334-2034
Practice Address - Country:US
Practice Address - Phone:573-324-5655
Practice Address - Fax:573-324-5490
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003023378101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1104849983Medicaid