Healthcare Provider Details

I. General information

NPI: 1538092085
Provider Name (Legal Business Name): WILLIAM BARNES LPC-A
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

882 WILLOW TREE CIR STE 102
CORDOVA TN
38018-3118
US

IV. Provider business mailing address

1728 WILLISSHIRE LN
GERMANTOWN TN
38139-3274
US

V. Phone/Fax

Practice location:
  • Phone: 901-670-7412
  • Fax:
Mailing address:
  • Phone: 901-292-2339
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number8738
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: