Provider Demographics
NPI:1356969810
Name:SALLY BARBAT PLLC
Entity type:Organization
Organization Name:SALLY BARBAT PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MASTER LEVEL PSYCHOLOGIST
Authorized Official - Prefix:MS
Authorized Official - First Name:SALLY
Authorized Official - Middle Name:
Authorized Official - Last Name:BARBAT
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LLP
Authorized Official - Phone:734-265-0841
Mailing Address - Street 1:21500 HAGGERTY RD STE 350
Mailing Address - Street 2:
Mailing Address - City:NORTHVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48167-8990
Mailing Address - Country:US
Mailing Address - Phone:734-265-0841
Mailing Address - Fax:
Practice Address - Street 1:21500 HAGGERTY RD STE 350
Practice Address - Street 2:
Practice Address - City:NORTHVILLE
Practice Address - State:MI
Practice Address - Zip Code:48167-8990
Practice Address - Country:US
Practice Address - Phone:734-265-0841
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-10
Last Update Date:2025-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty