Provider Demographics
NPI:1417395393
Name:O'ROURKE, BARBARA JOANNE (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:JOANNE
Last Name:O'ROURKE
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:JOANNE
Other - Middle Name:MCFARLAND
Other - Last Name:O'ROURKE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW, LCSW
Mailing Address - Street 1:721 W CENTRE AVE
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:MI
Mailing Address - Zip Code:49024-5309
Mailing Address - Country:US
Mailing Address - Phone:269-330-7030
Mailing Address - Fax:269-532-1907
Practice Address - Street 1:721 W CENTRE AVE
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:MI
Practice Address - Zip Code:49024-5309
Practice Address - Country:US
Practice Address - Phone:269-330-7030
Practice Address - Fax:269-532-1907
Is Sole Proprietor?:No
Enumeration Date:2013-06-12
Last Update Date:2016-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010954731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical