Provider Demographics
NPI:1598126039
Name:BARHOME, DAVID (MHC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:BARHOME
Suffix:
Gender:M
Credentials:MHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:191 BETHPAGE SWEET HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:OLD BETHPAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11804-1342
Mailing Address - Country:US
Mailing Address - Phone:516-870-1665
Mailing Address - Fax:516-870-1656
Practice Address - Street 1:191 BETHPAGE SWEET HOLLOW RD
Practice Address - Street 2:
Practice Address - City:OLD BETHPAGE
Practice Address - State:NY
Practice Address - Zip Code:11804-1342
Practice Address - Country:US
Practice Address - Phone:516-870-1665
Practice Address - Fax:516-870-1656
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-11
Last Update Date:2016-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP01106101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health