Healthcare Provider Details

I. General information

NPI: 1982475836
Provider Name (Legal Business Name): KRISTEN BARKER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2024
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

557 FREMAUX AVE
SLIDELL LA
70458-3319
US

IV. Provider business mailing address

557 FREMAUX AVE
SLIDELL LA
70458-3319
US

V. Phone/Fax

Practice location:
  • Phone: 985-771-1742
  • Fax: 866-593-6775
Mailing address:
  • Phone: 985-771-1742
  • Fax: 866-593-6775

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPLC10731
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: