MEDICARE: RICK BARNEY MSW, LCSW, LCAS, MAC

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	1041C0700X	Clinical Social Worker	P008788	NC

General Provider Information

NPI Number	:	1174936314
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICK BARNEY MSW, LCSW, LCAS, MAC

Provider Business Mailing Address
First Line	:	5027 WRIGHTSVILLE AVE
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28403-7046
Country	:	US
Telephone Number	:	828-772-6121
Fax Number	:

Provider Business Practice Location Address
First Line	:	5027 WRIGHTSVILLE AVE
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28403-7046
Country	:	US
Telephone Number	:	828-772-6121
Fax Number	:

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

Provider Enumeration Date	:	06/05/2014
Last Update Date	:	06/21/2022

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