Provider Demographics
NPI:1336499219
Name:BARKER, ANGELA (LCPC)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:BARKER
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 S MCARTHUR ST
Mailing Address - Street 2:
Mailing Address - City:MACOMB
Mailing Address - State:IL
Mailing Address - Zip Code:61455-2983
Mailing Address - Country:US
Mailing Address - Phone:309-833-2255
Mailing Address - Fax:309-833-2255
Practice Address - Street 1:233 S MCARTHUR ST
Practice Address - Street 2:
Practice Address - City:MACOMB
Practice Address - State:IL
Practice Address - Zip Code:61455-2983
Practice Address - Country:US
Practice Address - Phone:309-833-2255
Practice Address - Fax:309-833-2251
Is Sole Proprietor?:No
Enumeration Date:2012-09-18
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.008389106H00000X
IL180009582101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist