Healthcare Provider Details

I. General information

NPI: 1780244889
Provider Name (Legal Business Name): LAKEISHA BARNES LCSW, LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/19/2019
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10030 GREEN LEVEL CHURCH RD STE 802-2009
CARY NC
27519-8194
US

IV. Provider business mailing address

10030 GREEN LEVEL CHURCH RD STE 802-2009
CARY NC
27519-8194
US

V. Phone/Fax

Practice location:
  • Phone: 205-616-1147
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC013575
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number125682
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number4371C
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: