Provider Demographics
NPI:1437697349
Name:VANHOUTEN, BARBARA SUE (LCSW)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:SUE
Last Name:VANHOUTEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3843 CORNICE FALLS DR APT 1
Mailing Address - Street 2:
Mailing Address - City:HOLT
Mailing Address - State:MI
Mailing Address - Zip Code:48842-9800
Mailing Address - Country:US
Mailing Address - Phone:517-715-7540
Mailing Address - Fax:
Practice Address - Street 1:117 GOVERNORS SQ
Practice Address - Street 2:
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-4811
Practice Address - Country:US
Practice Address - Phone:517-715-7540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-10
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011154461041C0700X
1041C0700X, 225400000X
GACSW0084201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner