Basic Information
Provider Information
NPI: 1396118451
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BARGER
FirstName: ANNE
MiddleName: C
NamePrefix:  
NameSuffix:  
Credential: MS
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1300 N 17TH AVE
Address2:  
City: GREELEY
State: CO
PostalCode: 806319584
CountryCode: US
TelephoneNumber: 9703472120
FaxNumber:  
Practice Location
Address1: 1140 M ST
Address2:  
City: GREELEY
State: CO
PostalCode: 806319586
CountryCode: US
TelephoneNumber: 9703533900
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/10/2015
LastUpdateDate: 09/16/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/16/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YP2500XLPC.0016091COY Behavioral Health & Social Service ProvidersCounselorProfessional

No ID Information.


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