Provider Demographics
NPI:1326837444
Name:BARBARA J SHOCK LLC
Entity type:Organization
Organization Name:BARBARA J SHOCK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHOCK
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:612-405-2842
Mailing Address - Street 1:2730 HERSCHEL ST N APT 322
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55113-0033
Mailing Address - Country:US
Mailing Address - Phone:612-405-2842
Mailing Address - Fax:
Practice Address - Street 1:2730 HERSCHEL ST N APT 322
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55113-0033
Practice Address - Country:US
Practice Address - Phone:612-405-2842
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)