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General NPI Number Information
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NPI Number | 1912230160
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Entity Type | Organization
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Legal Business Name | MELODY BARNES, LCSW LAC, INC.
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Dates
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Enumeration Date | 09/04/2009
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Last Update Date | 10/05/2016
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Provider Practice Location Address
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Address Line | 127 N. HIGGINS SUITE 302
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City | MISSOULA
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State | MT
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Zip | 59802-4457
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Country | US
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Telephone | 406-926-6360
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Fax | 406-721-6901
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Provider Business Mailing Address
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Address Line | PO BOX 4901
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City | MISSOULA
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State | MT
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Zip | 59806-4901
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Country | US
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Telephone | 406-926-6360
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Fax | 406-721-6901
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Authorized Official
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Title or Position | PROVIDER / OWNER
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Name | MRS. MELODY L BARNES
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Credential | LCSW LAC
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Telephone | 406-926-6360
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 423
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License Number State | MT
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 699
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License Number State | MT
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