MEDICARE: GRANT BARLOW LPCC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	E.2404580	OH
2	101YP2500X	Professional Counselor	180.012006	IL

General Provider Information

NPI Number	:	1154967982
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GRANT BARLOW LPCC

Provider Business Mailing Address
First Line	:	1530 LINCOLN AVE UNIT G
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45206-1684
Country	:	US
Telephone Number	:	773-573-6727
Fax Number	:

Provider Business Practice Location Address
First Line	:	4610 N CLARK ST # 1010
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60640-4620
Country	:	US
Telephone Number	:	773-242-8261
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/27/2019
Last Update Date	:	09/27/2025

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