Provider Demographics
NPI:1720423585
Name:BARNHILL, PHILLIP JEFFERY (LBSW, IPR)
Entity Type:Individual
Prefix:MR
First Name:PHILLIP
Middle Name:JEFFERY
Last Name:BARNHILL
Suffix:
Gender:M
Credentials:LBSW, IPR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 S. PECAN
Mailing Address - Street 2:
Mailing Address - City:WHITE OAK
Mailing Address - State:TX
Mailing Address - Zip Code:75693-1824
Mailing Address - Country:US
Mailing Address - Phone:903-295-1208
Mailing Address - Fax:
Practice Address - Street 1:304 S. PECAN
Practice Address - Street 2:
Practice Address - City:WHITE OAK
Practice Address - State:TX
Practice Address - Zip Code:75693-1824
Practice Address - Country:US
Practice Address - Phone:903-295-1208
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-07
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10281104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker