Provider Demographics
NPI:1265855407
Name:BARBOUR, ANADEL BAUGHN (PHD, LMFT)
Entity Type:Individual
Prefix:DR
First Name:ANADEL
Middle Name:BAUGHN
Last Name:BARBOUR
Suffix:
Gender:F
Credentials:PHD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 N LARCHMONT BLVD STE 506
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90004-6405
Mailing Address - Country:US
Mailing Address - Phone:323-488-3335
Mailing Address - Fax:
Practice Address - Street 1:321 N LARCHMONT BLVD STE 506
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90004-6405
Practice Address - Country:US
Practice Address - Phone:323-488-3335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-23
Last Update Date:2017-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CA103225106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty