Provider Demographics
NPI:1053546010
Name:BARKER, JANE D (LPC, ICADC)
Entity type:Individual
Prefix:MS
First Name:JANE
Middle Name:D
Last Name:BARKER
Suffix:
Gender:F
Credentials:LPC, ICADC
Other - Prefix:MS
Other - First Name:JANE
Other - Middle Name:CRAIG
Other - Last Name:BARKER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:TX COUNSELOR
Mailing Address - Street 1:903 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:NACOGDOCHES
Mailing Address - State:TX
Mailing Address - Zip Code:75961-4479
Mailing Address - Country:US
Mailing Address - Phone:936-615-7731
Mailing Address - Fax:
Practice Address - Street 1:903 NORTH ST
Practice Address - Street 2:
Practice Address - City:NACOGDOCHES
Practice Address - State:TX
Practice Address - Zip Code:75961-4479
Practice Address - Country:US
Practice Address - Phone:936-615-7731
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-20
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2056 CERTIFICATION #101YA0400X
TX1807101YP2500X
120328 CERT.101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)