Provider Demographics
NPI:1790026904
Name:BARNARD, LORI K (MA LLPC)
Entity Type:Individual
Prefix:MS
First Name:LORI
Middle Name:K
Last Name:BARNARD
Suffix:
Gender:F
Credentials:MA LLPC
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:K
Other - Last Name:BARNARD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA LLPC
Mailing Address - Street 1:105 HALL ST UNIT A
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684-2288
Mailing Address - Country:US
Mailing Address - Phone:231-935-3657
Mailing Address - Fax:
Practice Address - Street 1:105 HALL ST UNIT A
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-2288
Practice Address - Country:US
Practice Address - Phone:231-935-3657
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-13
Last Update Date:2013-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401012826101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health