Provider Demographics
NPI:1518190636
Name:BARLOW, SHIRLEY R (LCPC)
Entity Type:Individual
Prefix:MS
First Name:SHIRLEY
Middle Name:R
Last Name:BARLOW
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 GREEN ST
Mailing Address - Street 2:
Mailing Address - City:THOMASTON
Mailing Address - State:ME
Mailing Address - Zip Code:04861-3732
Mailing Address - Country:US
Mailing Address - Phone:207-975-9099
Mailing Address - Fax:
Practice Address - Street 1:60 MAIN ST
Practice Address - Street 2:ROOM 201 THOMASTON ACADEMY BLD.
Practice Address - City:THOMASTON
Practice Address - State:ME
Practice Address - Zip Code:04861-3611
Practice Address - Country:US
Practice Address - Phone:207-975-9099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-25
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC600101Y00000X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health