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General NPI Number Information
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NPI Number | 1215417084
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Entity Type | Individual
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Provider Name | KRISTY WAKEFIELD BARNES MS, LPC
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Gender | Female
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Dates
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Enumeration Date | 08/20/2018
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Last Update Date | 08/31/2021
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Provider Practice Location Address
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Address Line | 745 CRAIG RD STE 210
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City | CREVE COEUR
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State | MO
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Zip | 63141-7122
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Country | US
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Telephone | 314-877-8489
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Fax |
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Provider Business Mailing Address
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Address Line | 17 JUNCTION DR # 255
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City | GLEN CARBON
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State | IL
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Zip | 62034-4300
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Country | US
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Telephone | 314-877-8489
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 2013014593
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License Number State | MO
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