Provider Demographics
NPI:1750900429
Name:BARGA, PATRICK (LPC)
Entity type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:
Last Name:BARGA
Suffix:
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 1:344 S LATAH ST APT 202
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83705-5175
Mailing Address - Country:US
Mailing Address - Phone:208-421-4622
Mailing Address - Fax:
Practice Address - Street 1:344 S LATAH ST APT 202
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83705-5175
Practice Address - Country:US
Practice Address - Phone:208-421-4622
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-13
Last Update Date:2020-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLPC-7574101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty