Provider Demographics
NPI:1871311928
Name:JOHNSON, BARRY (QMHS)
Entity type:Individual
Prefix:
First Name:BARRY
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:QMHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 165
Mailing Address - Street 2:
Mailing Address - City:NEW CONCORD
Mailing Address - State:OH
Mailing Address - Zip Code:43762-0165
Mailing Address - Country:US
Mailing Address - Phone:740-584-5220
Mailing Address - Fax:740-870-2631
Practice Address - Street 1:365 AIRPORT RD
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-0917
Practice Address - Country:US
Practice Address - Phone:740-584-5223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-27
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician