Provider Demographics
NPI:1669481693
Name:BARBER, AVERY LEE JR (MED, LPC)
Entity Type:Individual
Prefix:MR
First Name:AVERY
Middle Name:LEE
Last Name:BARBER
Suffix:JR
Gender:M
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:627 W INNES ST
Mailing Address - Street 2:STE 309
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28144-4101
Mailing Address - Country:US
Mailing Address - Phone:704-633-4001
Mailing Address - Fax:360-838-9606
Practice Address - Street 1:627 W INNES ST
Practice Address - Street 2:STE 309
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-4101
Practice Address - Country:US
Practice Address - Phone:704-633-4001
Practice Address - Fax:360-838-9606
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC088101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC13148OtherBLUE CROSS BLUE SHIELD