Basic Information
| Provider Information | |||||||||
| NPI: | 1760844526 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BARNES | ||||||||
| FirstName: | KATHLEEN | ||||||||
| MiddleName: | S | ||||||||
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| Credential: | LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7424 BROCK RD | ||||||||
| Address2: | P O BOX 277 | ||||||||
| City: | SPOTSYLVANIA | ||||||||
| State: | VA | ||||||||
| PostalCode: | 225532002 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5405823980 | ||||||||
| FaxNumber: | 5403713753 | ||||||||
| Practice Location | |||||||||
| Address1: | 7424 BROCK RD | ||||||||
| Address2: | |||||||||
| City: | SPOTSYLVANIA | ||||||||
| State: | VA | ||||||||
| PostalCode: | 225532002 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5405823980 | ||||||||
| FaxNumber: | 5403713753 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/22/2016 | ||||||||
| LastUpdateDate: | 07/22/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 07/22/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 0701006510 | VA | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.