Healthcare Provider Details

I. General information

NPI: 1801120431
Provider Name (Legal Business Name): CHERIE L BARNES NCC, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2009
Last Update Date: 02/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 W 79TH ST
CHICAGO IL
60620-5720
US

IV. Provider business mailing address

2020 W 79TH ST
CHICAGO IL
60620-5720
US

V. Phone/Fax

Practice location:
  • Phone: 773-592-1716
  • Fax:
Mailing address:
  • Phone: 773-592-1716
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number178.005104
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: