Provider Demographics
NPI:1922255561
Name:BARR, ANTONINA (LCSW)
Entity Type:Individual
Prefix:
First Name:ANTONINA
Middle Name:
Last Name:BARR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 S RIVER ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60506-5295
Mailing Address - Country:US
Mailing Address - Phone:630-844-2662
Mailing Address - Fax:630-844-3084
Practice Address - Street 1:70 S RIVER ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60506-5295
Practice Address - Country:US
Practice Address - Phone:630-844-2662
Practice Address - Fax:630-844-3084
Is Sole Proprietor?:No
Enumeration Date:2008-08-26
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490129271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical