Provider Demographics
NPI:1952545360
Name:BARBARISI, BEVERLY H (LMHC)
Entity type:Individual
Prefix:MRS
First Name:BEVERLY
Middle Name:H
Last Name:BARBARISI
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 HOSPITAL DR.
Mailing Address - Street 2:
Mailing Address - City:FORT WALTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32548-5063
Mailing Address - Country:US
Mailing Address - Phone:850-833-7400
Mailing Address - Fax:850-833-7528
Practice Address - Street 1:299 W RAILROAD AVE
Practice Address - Street 2:
Practice Address - City:CRESTVIEW
Practice Address - State:FL
Practice Address - Zip Code:32536-4053
Practice Address - Country:US
Practice Address - Phone:850-689-7810
Practice Address - Fax:850-689-7434
Is Sole Proprietor?:No
Enumeration Date:2009-04-29
Last Update Date:2011-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 4619101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL761886700Medicaid