Provider Demographics
NPI:1053357483
Name:BARCUS, ROBERT A (PHD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:A
Last Name:BARCUS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 XENIA AVE
Mailing Address - Street 2:
Mailing Address - City:YELLOW SPRINGS
Mailing Address - State:OH
Mailing Address - Zip Code:45387-1832
Mailing Address - Country:US
Mailing Address - Phone:937-767-7044
Mailing Address - Fax:937-767-5066
Practice Address - Street 1:213 XENIA AVE
Practice Address - Street 2:
Practice Address - City:YELLOW SPRINGS
Practice Address - State:OH
Practice Address - Zip Code:45387-1832
Practice Address - Country:US
Practice Address - Phone:937-767-7044
Practice Address - Fax:937-767-5066
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3494103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0648393Medicaid
OHBACP00701Medicare ID - Type Unspecified
OH0648393Medicaid