Provider Demographics
NPI:1124418298
Name:BARKER, RONALD EMMANUEL (LCSW, MAC, SAP)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:EMMANUEL
Last Name:BARKER
Suffix:
Gender:M
Credentials:LCSW, MAC, SAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1119 W KENT AVE STE C
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59801-6633
Mailing Address - Country:US
Mailing Address - Phone:406-880-3275
Mailing Address - Fax:
Practice Address - Street 1:1119 W KENT AVE STE C
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801-6633
Practice Address - Country:US
Practice Address - Phone:406-880-3275
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-28
Last Update Date:2020-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTLAC-LAC-LIC-4244101YA0400X
MTBBH-LCSW-LIC-427231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)