Provider Demographics
NPI:1730329582
Name:KOVAZ, BARBARA A (PHD)
Entity type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:A
Last Name:KOVAZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 OLMSTED LN
Mailing Address - Street 2:
Mailing Address - City:FLAT ROCK
Mailing Address - State:NC
Mailing Address - Zip Code:28731-4748
Mailing Address - Country:US
Mailing Address - Phone:828-595-3541
Mailing Address - Fax:828-595-3541
Practice Address - Street 1:15 MARKET CENTER DR
Practice Address - Street 2:SUITE C
Practice Address - City:FLAT ROCK
Practice Address - State:NC
Practice Address - Zip Code:28731-8528
Practice Address - Country:US
Practice Address - Phone:828-702-4223
Practice Address - Fax:828-702-4223
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-05
Last Update Date:2013-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3770101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6102630Medicaid