Healthcare Provider Details

I. General information

NPI: 1396231213
Provider Name (Legal Business Name): BRIAN SCOTT BARNETT QMHS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2018
Last Update Date: 09/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

49 TOWNSHIP ROAD 365
SOUTH POINT OH
45680-9409
US

IV. Provider business mailing address

PO BOX 108
IRONTON OH
45638-0108
US

V. Phone/Fax

Practice location:
  • Phone: 740-451-0221
  • Fax: 740-451-0771
Mailing address:
  • Phone: 740-532-1613
  • Fax: 740-532-1715

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCDCA.168073
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: