Provider Demographics
NPI:1336355452
Name:BAROODY, ALBERT JOSEPH JR (DOCTOR OF MINISTRY)
Entity Type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:JOSEPH
Last Name:BAROODY
Suffix:JR
Gender:M
Credentials:DOCTOR OF MINISTRY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:252 S DARGAN ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29506-2534
Mailing Address - Country:US
Mailing Address - Phone:843-662-0000
Mailing Address - Fax:843-669-9943
Practice Address - Street 1:252 S DARGAN ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29506-2534
Practice Address - Country:US
Practice Address - Phone:843-662-0000
Practice Address - Fax:843-669-9943
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1459101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral