Provider Demographics
NPI:1245321744
Name:BARGER, KERRY (LPC)
Entity type:Individual
Prefix:
First Name:KERRY
Middle Name:
Last Name:BARGER
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5232
Mailing Address - Street 2:
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73702-5232
Mailing Address - Country:US
Mailing Address - Phone:580-478-2538
Mailing Address - Fax:
Practice Address - Street 1:2101 N MEADOWBROOK DR
Practice Address - Street 2:
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73701-2568
Practice Address - Country:US
Practice Address - Phone:580-478-2538
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2012-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200292020AMedicaid
OK200292020BMedicaid