Provider Demographics
NPI:1932070950
Name:VANDERPOL, BARBARA ANITA (CLINICAL PSYCHOLOGIS)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:ANITA
Last Name:VANDERPOL
Suffix:
Gender:F
Credentials:CLINICAL PSYCHOLOGIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5525 FLAG WAY
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80919-4418
Mailing Address - Country:US
Mailing Address - Phone:719-761-5955
Mailing Address - Fax:
Practice Address - Street 1:5525 FLAG WAY
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80919-4418
Practice Address - Country:US
Practice Address - Phone:719-761-5955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-15
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0006773103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty