Healthcare Provider Details

I. General information

NPI: 1255855128
Provider Name (Legal Business Name): JAMIE MICHELLE BARNETT LCSWA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2017
Last Update Date: 11/12/2021
Certification Date: 11/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 WELLINGTON AVE STE A
WILMINGTON NC
28401-7665
US

IV. Provider business mailing address

62 FLOYD ST
WHITEVILLE NC
28472-6510
US

V. Phone/Fax

Practice location:
  • Phone: 910-392-4881
  • Fax:
Mailing address:
  • Phone: 828-280-0546
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberP016881
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: