Provider Demographics
NPI:1598974206
Name:NORTHRUP, BARBARA ANN (LMSW)
Entity Type:Individual
Prefix:MISS
First Name:BARBARA
Middle Name:ANN
Last Name:NORTHRUP
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17242 BENTLER ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48219-4746
Mailing Address - Country:US
Mailing Address - Phone:313-535-8323
Mailing Address - Fax:
Practice Address - Street 1:17242 BENTLER ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48219-4746
Practice Address - Country:US
Practice Address - Phone:313-535-8323
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010339361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical