MEDICARE: NICOLE BARNES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	A22252	NC

General Provider Information

NPI Number	:	1033072400
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE BARNES

Provider Business Mailing Address
First Line	:	103 ADVENTURE TRL
Second Line	:
City	:	CARY
State	:	NC
Zip	:	27513-4219
Country	:	US
Telephone Number	:	910-916-8958
Fax Number	:

Provider Business Practice Location Address
First Line	:	1903 N HARRISON AVE STE 100
Second Line	:
City	:	CARY
State	:	NC
Zip	:	27513-3003
Country	:	US
Telephone Number	:	919-463-7890
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/03/2025
Last Update Date	:	12/03/2025

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Directions to “ NICOLE BARNES ” Practice Location

Language	Start Address	Practice Location

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