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NPI Code Detail

MEDICARE: KEITH JAMES BARNETT LCSW

MEDICARE: KEITH JAMES BARNETT 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
1101YA0400XAddiction (Substance Use Disorder) Counselor020573CA
2101YM0800XMental Health Counselor70624CA
31041C0700XClinical Social Worker70624CA

General Provider Information

NPI Number : 1972764660
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEITH JAMES BARNETT LCSW
Provider Business Mailing Address
First Line : PO BOX 491750
Second Line :
City : REDDING
State : CA
Zip : 96049-1750
Country : US
Telephone Number : 530-736-8916
Fax Number :
Provider Business Practice Location Address
First Line : 22425 SUNBRIGHT AVE
Second Line :
City : RED BLUFF
State : CA
Zip : 96080-9741
Country : US
Telephone Number : 530-528-2342
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/24/2008
Last Update Date : 06/19/2019

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