MEDICARE: CERENITY LEAVELL-BARKER MSW, LCSW

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	254285	KY

General Provider Information

NPI Number	:	1952982357
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CERENITY LEAVELL-BARKER MSW, LCSW

Provider Business Mailing Address
First Line	:	3389 PUEBLO CT
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40509-8441
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	713 MILLPOND RD
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40514-1570
Country	:	US
Telephone Number	:	859-309-2877
Fax Number	:

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

Provider Enumeration Date	:	04/16/2021
Last Update Date	:	04/16/2021

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