Healthcare Provider Details

I. General information

NPI: 1720547169
Provider Name (Legal Business Name): BARBARA M VONDERHARR PHD, LPC, LAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2019
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 PEACHTREE ST NE
ATLANTA GA
30361-3503
US

IV. Provider business mailing address

11177 HAHN RD
CALHAN CO
80808-9212
US

V. Phone/Fax

Practice location:
  • Phone: 719-641-0594
  • Fax:
Mailing address:
  • Phone: 719-632-3510
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC016653
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberACD.0002108
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: