Healthcare Provider Details

I. General information

NPI: 1265628812
Provider Name (Legal Business Name): KEVIN BARWICK LCPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/18/2007
Last Update Date: 09/18/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6944 NASHVILLE RD
LANHAM MD
20706-4614
US

IV. Provider business mailing address

6944 NASHVILLE RD
LANHAM MD
20706-4614
US

V. Phone/Fax

Practice location:
  • Phone: 301-552-6688
  • Fax: 301-552-8904
Mailing address:
  • Phone: 301-552-6688
  • Fax: 301-552-8904

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLC0255
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: