MEDICARE: KATHRYN BARNARD MSW

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

General Provider Information

NPI Number	:	1568713766
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHRYN BARNARD MSW

Provider Business Mailing Address
First Line	:	261 GREEN MANOR TER
Second Line	:
City	:	WINDSOR LOCKS
State	:	CT
Zip	:	06096-2736
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	261 GREEN MANOR TER
Second Line	:
City	:	WINDSOR LOCKS
State	:	CT
Zip	:	06096-2736
Country	:	US
Telephone Number	:	860-989-6634
Fax Number	:

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

Provider Enumeration Date	:	09/27/2012
Last Update Date	:	09/27/2012

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