MEDICARE: STEPHANIE BARNETT LPC, ADC

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	ACD.0001115	CO
2	101YP2500X	Professional Counselor	LPCC.0015070	CO

General Provider Information

NPI Number	:	1215460225
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE BARNETT LPC, ADC

Provider Business Mailing Address
First Line	:	10758 W 68TH WAY
Second Line	:
City	:	ARVADA
State	:	CO
Zip	:	80004-1412
Country	:	US
Telephone Number	:	720-917-4925
Fax Number	:

Provider Business Practice Location Address
First Line	:	12191 W 64TH AVE STE 109
Second Line	:
City	:	ARVADA
State	:	CO
Zip	:	80004-4030
Country	:	US
Telephone Number	:	720-917-4925
Fax Number	:

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

Provider Enumeration Date	:	04/06/2017
Last Update Date	:	08/23/2021

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