Provider Demographics
NPI:1184048316
Name:JOHN ADAM BARMORE LICENSED PSYCHOLOGICAL PRACTITIONER LLC
Entity type:Organization
Organization Name:JOHN ADAM BARMORE LICENSED PSYCHOLOGICAL PRACTITIONER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGICAL PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:ADAM
Authorized Official - Last Name:BARMORE
Authorized Official - Suffix:
Authorized Official - Credentials:LPP
Authorized Official - Phone:502-387-3891
Mailing Address - Street 1:1310 S 1ST ST
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40208-2302
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1310 S 1ST ST
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40208-2302
Practice Address - Country:US
Practice Address - Phone:502-387-3891
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-07
Last Update Date:2014-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0028251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health