MEDICARE: KRISTEN BARNES LCSW

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	1041C0700X	Clinical Social Worker	SW13819	FL

General Provider Information

NPI Number	:	1568913523
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTEN BARNES LCSW

Provider Business Mailing Address
First Line	:	2550 N ALAFAYA TRL
Second Line	:	APT 3202
City	:	ORLANDO
State	:	FL
Zip	:	32826-3605
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2550 N ALAFAYA TRL
Second Line	:	APT 3202
City	:	ORLANDO
State	:	FL
Zip	:	32826-3605
Country	:	US
Telephone Number	:	703-615-3606
Fax Number	:

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

Provider Enumeration Date	:	10/14/2016
Last Update Date	:	10/14/2016

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