Provider Demographics
NPI:1184980666
Name:BARLOW, PETER WINCHESTER (DMIN, LPC-S)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:WINCHESTER
Last Name:BARLOW
Suffix:
Gender:M
Credentials:DMIN, LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8539 ODYSSEY DR
Mailing Address - Street 2:
Mailing Address - City:UNIVERSAL CITY
Mailing Address - State:TX
Mailing Address - Zip Code:78148-2654
Mailing Address - Country:US
Mailing Address - Phone:512-757-5266
Mailing Address - Fax:
Practice Address - Street 1:2515 MCCULLOUGH AVE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78212-3584
Practice Address - Country:US
Practice Address - Phone:210-736-1762
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-09
Last Update Date:2012-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX58690101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional