Provider Demographics
NPI:1053562314
Name:BARNES, CARLA L (MSW)
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:L
Last Name:BARNES
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3887 OKEMOS RD
Mailing Address - Street 2:SUITE A2
Mailing Address - City:OKEMOS
Mailing Address - State:MI
Mailing Address - Zip Code:48864-3664
Mailing Address - Country:US
Mailing Address - Phone:517-347-3702
Mailing Address - Fax:517-347-3702
Practice Address - Street 1:3887 OKEMOS RD
Practice Address - Street 2:SUITE A2
Practice Address - City:OKEMOS
Practice Address - State:MI
Practice Address - Zip Code:48864-3664
Practice Address - Country:US
Practice Address - Phone:517-347-3702
Practice Address - Fax:517-347-3702
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-06
Last Update Date:2008-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010015591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical