Provider Demographics
NPI:1912033069
Name:BARKIS, MARITA (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARITA
Middle Name:
Last Name:BARKIS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4825 TROOST AVE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64110-2030
Mailing Address - Country:US
Mailing Address - Phone:816-235-1219
Mailing Address - Fax:816-235-5534
Practice Address - Street 1:1 WARD PKWY
Practice Address - Street 2:SUITE 107
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64112-2106
Practice Address - Country:US
Practice Address - Phone:816-756-1722
Practice Address - Fax:816-756-1533
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-25
Last Update Date:2007-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1374103TC1900X
KS0734103TC1900X
KS0018106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO16791016Medicare UPIN
6109531Medicare UPIN
MO178945Medicare UPIN