Provider Demographics
NPI:1891252946
Name:BARNEY, VIVIAN VENISE (LSW)
Entity type:Individual
Prefix:
First Name:VIVIAN
Middle Name:VENISE
Last Name:BARNEY
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15826 S LA GRANGE RD # 197
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-7793
Mailing Address - Country:US
Mailing Address - Phone:708-942-1683
Mailing Address - Fax:
Practice Address - Street 1:15826 S LA GRANGE RD # 197
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462-7793
Practice Address - Country:US
Practice Address - Phone:708-942-1683
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-25
Last Update Date:2024-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA150.115225101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor