Basic Information
Provider Information | |||||||||
NPI: | 1679547657 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | FINN | ||||||||
FirstName: | BARBARA | ||||||||
MiddleName: | K | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | LPC | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | PO BOX 239 | ||||||||
Address2: |   | ||||||||
City: | FISHERSVILLE | ||||||||
State: | VA | ||||||||
PostalCode: | 229390239 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 5409324629 | ||||||||
FaxNumber: | 5409325875 | ||||||||
Practice Location | |||||||||
Address1: | 79 N MEDICAL PARK DR | ||||||||
Address2: |   | ||||||||
City: | FISHERSVILLE | ||||||||
State: | VA | ||||||||
PostalCode: | 229392344 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 5402132525 | ||||||||
FaxNumber: | 5402132502 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 02/15/2006 | ||||||||
LastUpdateDate: | 03/18/2010 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 0701003514 | VA | Y |   | Behavioral Health & Social Service Providers | Counselor | Professional |
ID Information
ID | Type | State | Issuer | Description | 085274M | 01 | VA | OPTIMA BEHAVIORAL | OTHER | 5635244 | 01 | VA | FIRST HEALTH | OTHER | 2030558 | 01 | VA | CIGNA BEHAVIORAL | OTHER | 010181411 | 05 | VA |   | MEDICAID | 178451 | 01 | VA | ANTHEM BEHAVIORAL | OTHER |