Provider Demographics
NPI:1063810075
Name:BARBER, JERICA JALANE (LMHC, RN)
Entity type:Individual
Prefix:MS
First Name:JERICA
Middle Name:JALANE
Last Name:BARBER
Suffix:
Gender:F
Credentials:LMHC, RN
Other - Prefix:MS
Other - First Name:JERICA
Other - Middle Name:JALANE
Other - Last Name:TONEY-BARBER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMHC, RN
Mailing Address - Street 1:300 INTERNATIONAL DR STE 100
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-5783
Mailing Address - Country:US
Mailing Address - Phone:716-406-4246
Mailing Address - Fax:208-361-8666
Practice Address - Street 1:300 INTERNATIONAL DR
Practice Address - Street 2:SUITE 117
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-5781
Practice Address - Country:US
Practice Address - Phone:585-343-1681
Practice Address - Fax:208-361-8666
Is Sole Proprietor?:No
Enumeration Date:2014-12-08
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY22 537485163WA0400X, 163W00000X, 163WA2000X, 163WC1500X, 163WC1600X, 163WG0000X, 163WH0200X, 163WL0100X, 163WP0807X, 163WP0809X
NY18 006357101YA0400X, 101YP1600X, 101YM0800X, 222Q00000X, 374K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No163W00000XNursing Service ProvidersRegistered Nurse
No163WA2000XNursing Service ProvidersRegistered NurseAdministrator
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
No163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
No374K00000XNursing Service Related ProvidersReligious Nonmedical Practitioner