=====================================================
General NPI Number Information
=====================================================
NPI Number | 1124841432
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JOHN BARKEY MSW, LSW
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/05/2024
-----------------------------------------------------
Last Update Date | 11/05/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 250 CHAMBER PLZ
-----------------------------------------------------
City | CHARLEROI
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15022-1605
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 724-489-0320
-----------------------------------------------------
Fax | 724-489-0413
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3288 RAINBOW RUN RD
-----------------------------------------------------
City | MONONGAHELA
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15063-4511
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 724-797-3733
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | SW139900
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------