MEDICARE: MR. MICHAEL FRANCIS BARKEY LMSW

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	681011966	MI

General Provider Information

NPI Number	:	1518352723
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MICHAEL FRANCIS BARKEY LMSW

Provider Business Mailing Address
First Line	:	3697 PORTMAN LN SE
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49508-3784
Country	:	US
Telephone Number	:	616-551-9678
Fax Number	:

Provider Business Practice Location Address
First Line	:	3697 PORTMAN LN SE
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49508-3784
Country	:	US
Telephone Number	:	616-551-9678
Fax Number	:

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

Provider Enumeration Date	:	04/03/2015
Last Update Date	:	04/03/2015

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