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General NPI Number Information
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NPI Number | 1689334120
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Entity Type | Individual
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Provider Name | SHANNON R BARNES
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Gender | Female
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Dates
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Enumeration Date | 12/25/2021
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Last Update Date | 08/15/2025
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Provider Practice Location Address
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Address Line | 123 E AVENUE C
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City | HEAVENER
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State | OK
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Zip | 74937-2603
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Country | US
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Telephone | 918-658-4016
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Fax |
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Provider Business Mailing Address
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Address Line | 27675 PINE CREST WAY
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City | CAMERON
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State | OK
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Zip | 74932-2428
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Country | US
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Telephone |
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | 316000
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | LPCCANDIDATE12926
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License Number State | OK
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