Provider Demographics
NPI:1144533886
Name:BARNICK, HELEN LOUISE (MS)
Entity type:Individual
Prefix:
First Name:HELEN
Middle Name:LOUISE
Last Name:BARNICK
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:LOUISE
Other - Middle Name:MCCOY
Other - Last Name:BARNICK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS
Mailing Address - Street 1:2401 E ORANGEBURG AVE
Mailing Address - Street 2:SUITE 675 PMB 121
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95355-3351
Mailing Address - Country:US
Mailing Address - Phone:209-988-5669
Mailing Address - Fax:
Practice Address - Street 1:4132 COPPER CREEK DR
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95355-8965
Practice Address - Country:US
Practice Address - Phone:209-988-5669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-23
Last Update Date:2010-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46366106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist