Provider Demographics
NPI:1790722551
Name:BARKER, ALBERT DAVID (MSED)
Entity Type:Individual
Prefix:MR
First Name:ALBERT
Middle Name:DAVID
Last Name:BARKER
Suffix:
Gender:M
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7006 E KELLOGG DR
Mailing Address - Street 2:APT C
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67207-1616
Mailing Address - Country:US
Mailing Address - Phone:316-691-5032
Mailing Address - Fax:
Practice Address - Street 1:5500 E KELLOGG DR
Practice Address - Street 2:SATC, BUILDING 5, 2ND FLOOR
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67218-1607
Practice Address - Country:US
Practice Address - Phone:316-634-3095
Practice Address - Fax:316-634-3075
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0093101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)