Basic Information
| Provider Information | |||||||||
| NPI: | 1881195378 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BARKER | ||||||||
| FirstName: | LUKE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 41794 METZ RD | ||||||||
| Address2: | |||||||||
| City: | COLUMBIANA | ||||||||
| State: | OH | ||||||||
| PostalCode: | 444089408 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 40722 STATE ROUTE 154 | ||||||||
| Address2: | |||||||||
| City: | LISBON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 444328500 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3304249573 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/21/2018 | ||||||||
| LastUpdateDate: | 02/21/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | C.1700624-TRNE | OH | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
ID Information
| ID | Type | State | Issuer | Description | C.1700624-TRNE | 01 | OH | STATE LICENSE | OTHER |