Provider Demographics
NPI:1043756844
Name:MCINTOSH, BARBARA (LPN/BSBH)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:MCINTOSH
Suffix:
Gender:F
Credentials:LPN/BSBH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3732 W 2ND ST
Mailing Address - Street 2:
Mailing Address - City:NORTH PLATTE
Mailing Address - State:NE
Mailing Address - Zip Code:69101-4764
Mailing Address - Country:US
Mailing Address - Phone:308-339-3025
Mailing Address - Fax:
Practice Address - Street 1:1300 E 4TH ST STE C
Practice Address - Street 2:
Practice Address - City:NORTH PLATTE
Practice Address - State:NE
Practice Address - Zip Code:69101-4393
Practice Address - Country:US
Practice Address - Phone:308-330-3025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-17
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE7487101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)