Provider Demographics
NPI:1023438892
Name:BARBOUR, ANDREA (LMFT)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:BARBOUR
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:921 E 86TH ST
Mailing Address - Street 2:SUITE 210B
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46240-1859
Mailing Address - Country:US
Mailing Address - Phone:812-764-4931
Mailing Address - Fax:
Practice Address - Street 1:921 E 86TH ST
Practice Address - Street 2:SUITE 210B
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46240-1859
Practice Address - Country:US
Practice Address - Phone:812-764-4931
Practice Address - Fax:317-875-1060
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-21
Last Update Date:2016-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN35001920A101YM0800X, 106H00000X, 102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN35001920AOtherINDIANA LMFT LICENSE