Healthcare Provider Details

I. General information

NPI: 1295304483
Provider Name (Legal Business Name): MADELEINE BARKER LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2021
Last Update Date: 03/09/2023
Certification Date: 03/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2550 S DOUGLAS RD
CORAL GABLES FL
33134-6104
US

IV. Provider business mailing address

781 FAIRWAY DR
MIAMI FL
33141-2421
US

V. Phone/Fax

Practice location:
  • Phone: 305-456-1014
  • Fax:
Mailing address:
  • Phone: 786-837-1372
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberIMH20615
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH21964
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: