Provider Demographics
NPI:1063685899
Name:PEPPER, BARBARA V (PHD, LMHC)
Entity type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:V
Last Name:PEPPER
Suffix:
Gender:F
Credentials:PHD, LMHC
Other - Prefix:DR
Other - First Name:BARBARA
Other - Middle Name:V
Other - Last Name:PEPPER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD, LMHC
Mailing Address - Street 1:3003 SAINT JOHNS AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32205-9102
Mailing Address - Country:US
Mailing Address - Phone:904-382-4288
Mailing Address - Fax:
Practice Address - Street 1:1357 PALM AVE
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-8432
Practice Address - Country:US
Practice Address - Phone:904-382-4288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-13
Last Update Date:2008-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH5774101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health