MEDICARE: PROF. TIMOTHY L BARBER PCC-S

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.0004168-SUPV	OH

General Provider Information

NPI Number	:	1861677353
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PROF. TIMOTHY L BARBER PCC-S

Provider Business Mailing Address
First Line	:	1251 KEMPER MEADOW DR STE 100
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45240-1768
Country	:	US
Telephone Number	:	513-376-9757
Fax Number	:	513-376-8347

Provider Business Practice Location Address
First Line	:	1251 KEMPER MEADOW DR STE 100
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45240-1768
Country	:	US
Telephone Number	:	513-376-9757
Fax Number	:	513-376-8347

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

Provider Enumeration Date	:	01/03/2008
Last Update Date	:	09/03/2019

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