Provider Demographics
NPI:1164029005
Name:BARNHARDT, ADAM LYLE
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:LYLE
Last Name:BARNHARDT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1030NORTH VIRGIL AVE.
Mailing Address - Street 2:
Mailing Address - City:L.A.
Mailing Address - State:CA
Mailing Address - Zip Code:90029
Mailing Address - Country:US
Mailing Address - Phone:310-493-6126
Mailing Address - Fax:
Practice Address - Street 1:11500 PARAMONT BLVD.
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241
Practice Address - Country:US
Practice Address - Phone:562-923-4545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-05
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)