Provider Demographics
NPI:1689408742
Name:BARKER, RAQUEL LYN (LCSW)
Entity type:Individual
Prefix:
First Name:RAQUEL
Middle Name:LYN
Last Name:BARKER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1131 SE INDIAN ST
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34997-5765
Mailing Address - Country:US
Mailing Address - Phone:772-210-0913
Mailing Address - Fax:772-210-0871
Practice Address - Street 1:1131 SE INDIAN ST
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34997-5765
Practice Address - Country:US
Practice Address - Phone:772-210-0913
Practice Address - Fax:772-210-0871
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-29
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW191841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical