Healthcare Provider Details

I. General information

NPI: 1750300513
Provider Name (Legal Business Name): NATASHA BARNES LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 09/13/2022
Certification Date: 09/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11549 LAKE LN STE 2
CHISAGO CITY MN
55013-9201
US

IV. Provider business mailing address

848 217TH ST
OSCEOLA WI
54020-4504
US

V. Phone/Fax

Practice location:
  • Phone: 651-257-2733
  • Fax: 651-257-2783
Mailing address:
  • Phone: 651-210-6757
  • Fax: 651-257-2783

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number1395
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: