Provider Demographics
NPI:1376584029
Name:BARHAM, CARL SHERWOOD (LCPC)
Entity Type:Individual
Prefix:DR
First Name:CARL
Middle Name:SHERWOOD
Last Name:BARHAM
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5629 SHEEROCK CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-2530
Mailing Address - Country:US
Mailing Address - Phone:410-997-2641
Mailing Address - Fax:301-596-5952
Practice Address - Street 1:9189 RED BRANCH RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-2013
Practice Address - Country:US
Practice Address - Phone:410-992-3251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2015-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC0708101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD402166500Medicaid