Healthcare Provider Details

I. General information

NPI: 1861131492
Provider Name (Legal Business Name): WHITNEY BARNEY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2022
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1070 HILINE RD STE 340
POCATELLO ID
83201-2962
US

IV. Provider business mailing address

1070 HILINE RD STE 340
POCATELLO ID
83201-2962
US

V. Phone/Fax

Practice location:
  • Phone: 208-339-1068
  • Fax: 208-369-4968
Mailing address:
  • Phone: 208-339-1068
  • Fax: 208-369-4968

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number8911029
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: