Provider Demographics
NPI:1891100905
Name:BARRY, JOHANNA ENGLER (LSW)
Entity Type:Individual
Prefix:
First Name:JOHANNA
Middle Name:ENGLER
Last Name:BARRY
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 BELLFLOWER CIR
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03303-3408
Mailing Address - Country:US
Mailing Address - Phone:603-738-2549
Mailing Address - Fax:
Practice Address - Street 1:535 PLAINFIELD RD STE H
Practice Address - Street 2:
Practice Address - City:WILLOWBROOK
Practice Address - State:IL
Practice Address - Zip Code:60527-7607
Practice Address - Country:US
Practice Address - Phone:630-269-2886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-26
Last Update Date:2015-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical