Provider Demographics
NPI:1184349797
Name:BARNHART, JOHN JOSEPH (MA, TLLP, LLPC)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:JOSEPH
Last Name:BARNHART
Suffix:
Gender:M
Credentials:MA, TLLP, LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7095 FOXRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-3585
Mailing Address - Country:US
Mailing Address - Phone:734-656-8560
Mailing Address - Fax:
Practice Address - Street 1:41100 PLYMOUTH RD STE 110
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-3895
Practice Address - Country:US
Practice Address - Phone:734-656-8560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-05
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6362009622103TC0700X
MI6451022512101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional