Provider Demographics
NPI:1629128293
Name:BARBER, TERRY A (PLPC)
Entity type:Individual
Prefix:
First Name:TERRY
Middle Name:A
Last Name:BARBER
Suffix:
Gender:M
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1303 EDGEWOOD DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:MO
Mailing Address - Zip Code:65109-1943
Mailing Address - Country:US
Mailing Address - Phone:573-636-6727
Mailing Address - Fax:573-761-5819
Practice Address - Street 1:1303 EDGEWOOD DR
Practice Address - Street 2:SUITE 101
Practice Address - City:JEFFERSON CITY
Practice Address - State:MO
Practice Address - Zip Code:65109-1943
Practice Address - Country:US
Practice Address - Phone:573-636-6727
Practice Address - Fax:573-761-5819
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006036522101YM0800X, 101Y00000X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional