Provider Demographics
NPI:1306282728
Name:BARR, RICHARD ALAN JR (LCSW76119)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:ALAN
Last Name:BARR
Suffix:JR
Gender:M
Credentials:LCSW76119
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2745
Mailing Address - Street 2:
Mailing Address - City:HELENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:92342-2745
Mailing Address - Country:US
Mailing Address - Phone:951-202-3100
Mailing Address - Fax:
Practice Address - Street 1:1669 N E ST
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92405-4405
Practice Address - Country:US
Practice Address - Phone:909-886-6737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-13
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW761191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical