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General NPI Number Information
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NPI Number | 1184149866
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Entity Type | Organization
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Legal Business Name | KEVIN V. BARBER, PHD, MBA, PC
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Dates
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Enumeration Date | 08/03/2017
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Last Update Date | 08/03/2017
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Provider Practice Location Address
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Address Line | 25775 W 10 MILE RD STE C
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City | SOUTHFIELD
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State | MI
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Zip | 48033-4856
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Country | US
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Telephone | 248-971-0133
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Fax | 734-531-2361
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Provider Business Mailing Address
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Address Line | 2050 SOUTH BLVD PO BOX 757
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City | BLOOMFIELD HILLS
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State | MI
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Zip | 48303-0757
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Country | US
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Telephone | 248-755-0896
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. KEVIN V BARBER
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Credential | PHD, MBA
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Telephone | 248-755-0896
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 6301007614
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 103TA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Psychologist
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License Number | 6301007614
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | 6301007614
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 103TF0200X
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Taxonomy Name | Forensic Psychologist
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License Number | 6301007614
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License Number State | MI
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Taxonomy #5
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 6301007614
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License Number State | MI
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