MEDICARE: KHOURI BARNES PSY.D.

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	103T00000X	Psychologist	PSY004343	GA

General Provider Information

NPI Number	:	1164386041
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KHOURI BARNES PSY.D.

Provider Business Mailing Address
First Line	:	469 GREYFIELD DR
Second Line	:
City	:	CANTON
State	:	GA
Zip	:	30115-8918
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	469 GREYFIELD DR
Second Line	:
City	:	CANTON
State	:	GA
Zip	:	30115-8918
Country	:	US
Telephone Number	:	404-981-6071
Fax Number	:

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

Provider Enumeration Date	:	12/15/2025
Last Update Date	:	12/15/2025

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