Provider Demographics
NPI:1215135835
Name:CARL, BARBARA J (PC)
Entity type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:J
Last Name:CARL
Suffix:
Gender:F
Credentials:PC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3398 INGLESIDE RD
Mailing Address - Street 2:
Mailing Address - City:SHAKER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44122
Mailing Address - Country:US
Mailing Address - Phone:440-734-7872
Mailing Address - Fax:216-896-0735
Practice Address - Street 1:28790 CHAGRIN BLVD
Practice Address - Street 2:#260
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-4638
Practice Address - Country:US
Practice Address - Phone:440-734-7872
Practice Address - Fax:216-896-0735
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC. 0005519101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional