Provider Demographics
NPI:1912186370
Name:AGOR, BARBARA (MA, LCPC, DTR)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:AGOR
Suffix:
Gender:F
Credentials:MA, LCPC, DTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24402 W LOCKPORT ST
Mailing Address - Street 2:UNIT 2B
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60544-4206
Mailing Address - Country:US
Mailing Address - Phone:630-621-5824
Mailing Address - Fax:
Practice Address - Street 1:24402 W LOCKPORT ST
Practice Address - Street 2:UNIT 2B
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60544-4206
Practice Address - Country:US
Practice Address - Phone:630-621-5824
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-01
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional