Healthcare Provider Details

I. General information

NPI: 1215702501
Provider Name (Legal Business Name): MAILI BARR LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/16/2023
Last Update Date: 11/28/2023
Certification Date: 11/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5966 SCOTTSVILLE RD STE 3
BOWLING GREEN KY
42104-7908
US

IV. Provider business mailing address

5966 SCOTTSVILLE RD STE 3
BOWLING GREEN KY
42104-7908
US

V. Phone/Fax

Practice location:
  • Phone: 270-904-5104
  • Fax:
Mailing address:
  • Phone: 270-904-5104
  • Fax: 270-201-5980

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number258516
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: