Provider Demographics
NPI:1891031241
Name:BARBATO, ALLENA MARIA (AMFT)
Entity type:Individual
Prefix:MRS
First Name:ALLENA
Middle Name:MARIA
Last Name:BARBATO
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 S LAKE ST
Mailing Address - Street 2:
Mailing Address - City:GRAYSLAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60030-1511
Mailing Address - Country:US
Mailing Address - Phone:847-986-9314
Mailing Address - Fax:
Practice Address - Street 1:11 S LAKE ST
Practice Address - Street 2:
Practice Address - City:GRAYSLAKE
Practice Address - State:IL
Practice Address - Zip Code:60030-1511
Practice Address - Country:US
Practice Address - Phone:847-986-9314
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-12
Last Update Date:2012-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL208.000297106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist