Provider Demographics
NPI:1710352422
Name:MAULDING, BARBARA (LCPC)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:MAULDING
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 1:1566 SKYRIDGE DR UNIT 2
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60014-1027
Mailing Address - Country:US
Mailing Address - Phone:224-623-2251
Mailing Address - Fax:
Practice Address - Street 1:1566 SKYRIDGE DR UNIT 2
Practice Address - Street 2:
Practice Address - City:CRYSTAL LAKE
Practice Address - State:IL
Practice Address - Zip Code:60014-1027
Practice Address - Country:US
Practice Address - Phone:224-623-2251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-07
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180010906101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL180010906OtherLCPC