Provider Demographics
NPI:1124981667
Name:BARBER, SYRIC (LPCC)
Entity type:Individual
Prefix:
First Name:SYRIC
Middle Name:
Last Name:BARBER
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10540 64TH LN NE
Mailing Address - Street 2:
Mailing Address - City:ALBERTVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55301-3531
Mailing Address - Country:US
Mailing Address - Phone:612-990-5053
Mailing Address - Fax:
Practice Address - Street 1:102 MARTY DR STE 2
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:MN
Practice Address - Zip Code:55313-9345
Practice Address - Country:US
Practice Address - Phone:763-682-5420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-12-03
Last Update Date:2025-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNL763651164W00000X
MN5330101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No164W00000XNursing Service ProvidersLicensed Practical Nurse