Provider Demographics
NPI:1356451199
Name:BACKES, BARBARA GAY (MS, LPC, PA)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:GAY
Last Name:BACKES
Suffix:
Gender:F
Credentials:MS, LPC, PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 1ST ST N
Mailing Address - Street 2:#209
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-4256
Mailing Address - Country:US
Mailing Address - Phone:320-202-9107
Mailing Address - Fax:
Practice Address - Street 1:2700 1ST ST N
Practice Address - Street 2:#209
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-4256
Practice Address - Country:US
Practice Address - Phone:320-202-9107
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN00366101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional