MEDICARE: KIMBERLY ELIZABETH BARKER M.A., L.S.W.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	AP00941715	WV

General Provider Information

NPI Number	:	1023541281
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY ELIZABETH BARKER M.A., L.S.W.

Provider Business Mailing Address
First Line	:	RR 2 BOX 433
Second Line	:	9 WHITE OAK LANE
City	:	DELBARTON
State	:	WV
Zip	:	25670-9775
Country	:	US
Telephone Number	:	304-475-5249
Fax Number	:	304-475-5249

Provider Business Practice Location Address
First Line	:	RR 2 BOX 433
Second Line	:	9 WHITE OAK LANE
City	:	DELBARTON
State	:	WV
Zip	:	25670-9775
Country	:	US
Telephone Number	:	304-475-5249
Fax Number	:	304-475-5249

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/05/2017
Last Update Date	:	05/01/2017

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