Healthcare Provider Details
I. General information
NPI: 1295518157
Provider Name (Legal Business Name): BARBER MENTAL HEALTH ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/15/2023
Last Update Date: 04/26/2026
Certification Date: 04/26/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1714 A ST
LA PORTE IN
46350-5925
US
IV. Provider business mailing address
512 ANDREW AVE # 120
LA PORTE IN
46350-4633
US
V. Phone/Fax
- Phone: 219-342-2415
- Fax: 219-370-6088
- Phone: 219-369-2393
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
PHILIP
BARBER
Title or Position: CEO
Credential: LMHC
Phone: 219-369-2393