Stacy Jo Barber, L.C.P.C.
Individual provider Active NPI Professional Counselor · Dixon, IL
NPI 1073963963 · NPPES record last updated Jun 21, 2016
Key facts
- NPI
- 1073963963
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 180.009087 (IL)
- Practice address
- 820 Colony Rd
Dixon, IL 61021-9027 - Phone
- (773) 930-0994
- NPI assigned
- Jun 21, 2016
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 180.009087 | IL | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Roots & Wings Therapy LLC | Professional | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 180.009087 | IL | Yes |
Addresses
Primary practice location
820 Colony Rd
Dixon, IL 61021-9027
Mailing address
820 Colony Rd
Dixon, IL 61021-9027
Phone (773) 930-0994
Other providers in Dixon, IL
- Angela M Aurand
- Autism Center of Sauk Valley, LLC
- Tanja Babel
- Timothy Baker
- Diane Balcom
- Katelyn Bass
- Jenna Bauser
- Alexandra Baxter
- Allison Bay
- Gail L Beck
All providers in Dixon, IL · Professional Counselor in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 21, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.