Provider Demographics
NPI:1093535767
Name:BARBER, MATTHEW JOSHUA
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:JOSHUA
Last Name:BARBER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2413 W MAIN ST APT A
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23220-4436
Mailing Address - Country:US
Mailing Address - Phone:434-422-2580
Mailing Address - Fax:
Practice Address - Street 1:9844 LORI RD STE 100
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23832-6691
Practice Address - Country:US
Practice Address - Phone:434-422-2580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-16
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701014201101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional