Provider Demographics
NPI:1962534529
Name:KLOOS, BARBARA ANN (LCSW CACIII)
Entity type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:ANN
Last Name:KLOOS
Suffix:
Gender:F
Credentials:LCSW CACIII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2650 SUZANNE WAY
Mailing Address - Street 2:STE 120
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97408-7619
Mailing Address - Country:US
Mailing Address - Phone:541-228-3008
Mailing Address - Fax:541-228-3108
Practice Address - Street 1:2650 SUZANNE WAY
Practice Address - Street 2:STE 200
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97408-7619
Practice Address - Country:US
Practice Address - Phone:541-228-3008
Practice Address - Fax:541-228-3108
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2016-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL66751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO8532Medicare ID - Type Unspecified
CO9266Medicaid