Basic Information
| Provider Information | |||||||||
| NPI: | 1265709471 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BARNES | ||||||||
| FirstName: | ADONDE | ||||||||
| MiddleName: | |||||||||
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| Credential: | LCSW, LCAS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 401 MOYE BLVD | ||||||||
| Address2: | GREENVILLE VA HEALTHCARE CENTER (HCC) | ||||||||
| City: | GREENVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 278349079 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2528302149 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 401 MOYE BLVD | ||||||||
| Address2: | GREENVILLE VA HEALTHCARE CENTER (HCC) | ||||||||
| City: | GREENVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 278349079 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2528302149 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/17/2011 | ||||||||
| LastUpdateDate: | 05/19/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | N | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | 1041C0700X | C008266 | NC | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.