Provider Demographics
NPI:1740418599
Name:BARBOUR, WALSTON ERNEST JR (LPC)
Entity type:Individual
Prefix:MR
First Name:WALSTON
Middle Name:ERNEST
Last Name:BARBOUR
Suffix:JR
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2817 63RD AVENUE
Mailing Address - Street 2:
Mailing Address - City:CHEVERLY
Mailing Address - State:MD
Mailing Address - Zip Code:20785
Mailing Address - Country:US
Mailing Address - Phone:202-369-4743
Mailing Address - Fax:
Practice Address - Street 1:2817 63RD AVE
Practice Address - Street 2:
Practice Address - City:CHEVERLY
Practice Address - State:MD
Practice Address - Zip Code:20785-3104
Practice Address - Country:US
Practice Address - Phone:202-369-4743
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-30
Last Update Date:2009-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPRC14014174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist