Provider Demographics
NPI:1114327806
Name:HIGH TOP MANOR PSYCHOLOGICAL SERVICES
Entity Type:Organization
Organization Name:HIGH TOP MANOR PSYCHOLOGICAL SERVICES
Other - Org Name:DARLENE BARNES PHD.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:DARKEBE
Authorized Official - Middle Name:
Authorized Official - Last Name:BARNES
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:419-334-2200
Mailing Address - Street 1:503 GARRISON ST.
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:OH
Mailing Address - Zip Code:43420-2946
Mailing Address - Country:US
Mailing Address - Phone:419-334-2200
Mailing Address - Fax:419-334-8788
Practice Address - Street 1:503 GARRISON ST.
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:OH
Practice Address - Zip Code:43420-2946
Practice Address - Country:US
Practice Address - Phone:419-334-2200
Practice Address - Fax:419-334-8788
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HIGH TOP MANOR PSYCHOLOGICAL SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-08-29
Last Update Date:2014-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3915103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHCP08781Medicare UPIN