Provider Demographics
NPI:1356450209
Name:LEVENS, BARI F (AUD, CCC-A)
Entity Type:Individual
Prefix:MRS
First Name:BARI
Middle Name:F
Last Name:LEVENS
Suffix:
Gender:F
Credentials:AUD, CCC-A
Other - Prefix:
Other - First Name:BARI
Other - Middle Name:A
Other - Last Name:FRIEDBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD, CCC-A
Mailing Address - Street 1:340 NORTH BELAIR ROAD
Mailing Address - Street 2:
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-3000
Mailing Address - Country:US
Mailing Address - Phone:706-868-5676
Mailing Address - Fax:706-722-2824
Practice Address - Street 1:1303 DANTIGNAC STREET
Practice Address - Street 2:SUITE 1000
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30901-2776
Practice Address - Country:US
Practice Address - Phone:706-868-5676
Practice Address - Fax:706-722-2824
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2010-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAUD003739225000000X
GAAUD0003739231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA7060018218Medicaid
GA373758OtherWELLCARE