Healthcare Provider Details

I. General information

NPI: 1326248394
Provider Name (Legal Business Name): KIMBERLEE PALMER BARNES PSY.D., L.P.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2007
Last Update Date: 01/10/2020
Certification Date: 01/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

92 BURKE RDG
VAN BUREN MO
63965-7198
US

IV. Provider business mailing address

PO BOX 34
VAN BUREN MO
63965-0034
US

V. Phone/Fax

Practice location:
  • Phone: 678-571-8738
  • Fax: 706-850-0899
Mailing address:
  • Phone: 573-870-1959
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC002287
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY003042
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: