Provider Demographics
NPI:1902916430
Name:KURZ, BARRY FRANK (LCSW)
Entity type:Individual
Prefix:DR
First Name:BARRY
Middle Name:FRANK
Last Name:KURZ
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7802 N UNIVERSITY
Mailing Address - Street 2:SUITE 207
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61614-8302
Mailing Address - Country:US
Mailing Address - Phone:309-693-0111
Mailing Address - Fax:309-693-0112
Practice Address - Street 1:7802 N UNIVERSITY
Practice Address - Street 2:SUITE 207
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61614-8302
Practice Address - Country:US
Practice Address - Phone:309-693-0111
Practice Address - Fax:309-693-0112
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
0007271403OtherBCBS
2052421Medicare ID - Type Unspecified