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NPI 1245321744

NPI 1245321744 : KERRY BARGER LPC : ENID, OK

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General NPI Number Information
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    NPI Number           |    1245321744
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    Entity Type          |    Individual 
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    Provider Name        |    KERRY BARGER LPC
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    09/27/2006
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    Last Update Date     |    12/27/2012
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Provider Practice Location Address
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    Address Line         |    2101 N MEADOWBROOK DR 
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    City                 |    ENID
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    State                |    OK
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    Zip                  |    73701-2568
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    Country              |    US
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    Telephone            |    580-478-2538
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 5232 
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    City                 |    ENID
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    State                |    OK
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    Zip                  |    73702-5232
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    Country              |    US
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    Telephone            |    580-478-2538
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    101YM0800X
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    Taxonomy Name        |    Mental Health Counselor
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    License Number       |    
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    License Number State |    
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