Provider Demographics
NPI:1386633097
Name:ENSOR, BARBARA ELIZABETH (PHD)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:ELIZABETH
Last Name:ENSOR
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 RADSTOCK RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-5438
Mailing Address - Country:US
Mailing Address - Phone:410-747-5382
Mailing Address - Fax:410-747-5382
Practice Address - Street 1:8831 SATYR HILL RD
Practice Address - Street 2:SUITE 211
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21234-2306
Practice Address - Country:US
Practice Address - Phone:410-661-4635
Practice Address - Fax:410-747-5382
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02938103T00000X, 103TA0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDGL50OtherCAREFIRST
MDGL50OtherCAREFIRST
R89639Medicare UPIN