=====================================================
General NPI Number Information
=====================================================
NPI Number | 1114817558
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CLARIZEN COUNSELING & COACHING, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/07/2025
-----------------------------------------------------
Last Update Date | 07/07/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4439 W MOORE ST
-----------------------------------------------------
City | FARMVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27828-1777
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 252-814-3673
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4439 W MOORE ST
-----------------------------------------------------
City | FARMVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27828-1777
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 252-814-3673
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/OPERATOR
-----------------------------------------------------
Name | LAKEISHA RENEE BARNES
-----------------------------------------------------
Credential | LCMHCA
-----------------------------------------------------
Telephone | 252-814-3673
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------