Provider Demographics
NPI:1285196089
Name:BARNEY, REGINALD B (LMHCA)
Entity Type:Individual
Prefix:
First Name:REGINALD
Middle Name:B
Last Name:BARNEY
Suffix:
Gender:M
Credentials:LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3333 N ILLINOIS ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46208-4676
Mailing Address - Country:US
Mailing Address - Phone:219-545-9908
Mailing Address - Fax:317-384-1762
Practice Address - Street 1:3333 N ILLINOIS ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46208-4676
Practice Address - Country:US
Practice Address - Phone:219-545-9908
Practice Address - Fax:317-384-1762
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-02
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN88000820A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty