MEDICARE: NICKAYLYNN BARNER LPC

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	101YP2500X	Professional Counselor	95391	TX

General Provider Information

NPI Number	:	1801633474
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICKAYLYNN BARNER LPC

Provider Business Mailing Address
First Line	:	16790 MAMMOTH SPRINGS DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77095-5488
Country	:	US
Telephone Number	:	901-503-7145
Fax Number	:

Provider Business Practice Location Address
First Line	:	11301 FALLBROOK DR STE 300
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77065-4272
Country	:	US
Telephone Number	:	281-305-1578
Fax Number	:

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

Provider Enumeration Date	:	07/11/2024
Last Update Date	:	06/01/2026

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