Provider Demographics
NPI:1750580247
Name:BARKER, BEVERLY W (LPC, LMFT)
Entity type:Individual
Prefix:
First Name:BEVERLY
Middle Name:W
Last Name:BARKER
Suffix:
Gender:F
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 LONDONDERRY DR
Mailing Address - Street 2:SUITE 1
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76712-7929
Mailing Address - Country:US
Mailing Address - Phone:254-776-4850
Mailing Address - Fax:254-772-5178
Practice Address - Street 1:305 LONDONDERRY DR
Practice Address - Street 2:SUITE 1
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76712-7929
Practice Address - Country:US
Practice Address - Phone:254-776-4850
Practice Address - Fax:254-772-5178
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-13
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9490101YP2500X
TX2002106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist