Provider Demographics
NPI:1174092811
Name:WAY, BARBARA W (LPC, LPCC)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:W
Last Name:WAY
Suffix:
Gender:F
Credentials:LPC, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3267 BRIGGS AVE # B
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-4802
Mailing Address - Country:US
Mailing Address - Phone:310-850-3481
Mailing Address - Fax:
Practice Address - Street 1:3267 BRIGGS AVE # B
Practice Address - Street 2:
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-4802
Practice Address - Country:US
Practice Address - Phone:310-850-3481
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-23
Last Update Date:2018-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0011787101YP2500X
CA2993101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional