Provider Demographics
NPI:1538316039
Name:BARONA, JOHN H (EDD, LCPC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:H
Last Name:BARONA
Suffix:
Gender:M
Credentials:EDD, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 117
Mailing Address - Street 2:
Mailing Address - City:FERNLEY
Mailing Address - State:NV
Mailing Address - Zip Code:89408-0117
Mailing Address - Country:US
Mailing Address - Phone:775-404-1110
Mailing Address - Fax:775-636-6655
Practice Address - Street 1:79 7TH ST STE 4
Practice Address - Street 2:
Practice Address - City:FERNLEY
Practice Address - State:NV
Practice Address - Zip Code:89408-8745
Practice Address - Country:US
Practice Address - Phone:775-301-0727
Practice Address - Fax:775-636-6655
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-26
Last Update Date:2019-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00011041101YP2500X
NVCP0029101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1538316039Medicaid