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Provider Information for 1336122928


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Dr. TOM J BARBERA PhD


Sex: Male

NPI: 1336122928
Last Updated: 2024-06-11
Certification Date: 2024-06-11

Details

NameValue
NPI1336122928
Enumeration Date2005-11-28
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 395 WESTFIELD RD
NOBLESVILLE, IN 46060-1425
United States

Phone: 317-773-0760 | Fax:
 
Primary Practice Address 205 WESTFIELD RD
NOBLESVILLE, IN 46060-1424
United States

Phone: 317-770-2841 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
MEDICAIDIN200376530
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
No 103T00000X - Psychologist IN20041728A
Yes 103TC0700X - Psychologist - ClinicalIN20041728A