Provider Demographics
NPI:1467082446
Name:DEVOS, BARBRA LEA (LPC-MH-30600-SUPV)
Entity Type:Individual
Prefix:
First Name:BARBRA
Middle Name:LEA
Last Name:DEVOS
Suffix:
Gender:F
Credentials:LPC-MH-30600-SUPV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 S 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57104-6329
Mailing Address - Country:US
Mailing Address - Phone:605-275-1302
Mailing Address - Fax:605-339-3345
Practice Address - Street 1:408 W LOTTA ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-6809
Practice Address - Country:US
Practice Address - Phone:605-777-0588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-19
Last Update Date:2020-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDLPC-MH-30600-SUPV101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty