Provider Demographics
NPI:1477560860
Name:STOCK, BARBARA MORRIS (PHD)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:MORRIS
Last Name:STOCK
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 1:2530 CRAWFORD AVE
Mailing Address - Street 2:301
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-4970
Mailing Address - Country:US
Mailing Address - Phone:847-251-0288
Mailing Address - Fax:847-251-7164
Practice Address - Street 1:2530 CRAWFORD AVE
Practice Address - Street 2:301
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-4970
Practice Address - Country:US
Practice Address - Phone:847-251-0288
Practice Address - Fax:847-251-7164
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist