Provider Demographics
NPI:1518005669
Name:BARKER, JOHN (LPC MHSP)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:BARKER
Suffix:
Gender:M
Credentials:LPC MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 RULAND CIR
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-4617
Mailing Address - Country:US
Mailing Address - Phone:615-491-2569
Mailing Address - Fax:
Practice Address - Street 1:100 HAZEL PATH
Practice Address - Street 2:LEXINGTON BLDG SUITE B
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-3841
Practice Address - Country:US
Practice Address - Phone:615-491-2569
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2016-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X, 1041C0700X
TN2529101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3376955Medicare ID - Type UnspecifiedGROUP NUMBER