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NPI Code Detail

MEDICARE: MICHELLE NICOLE BARKER LMFT, MCAP, IC-ADC

MEDICARE: MICHELLE NICOLE BARKER LMFT, MCAP, IC-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
1101Y00000XCounselor
2101YA0400XAddiction (Substance Use Disorder) CounselorMCAP0100540FL
3101YA0400XAddiction (Substance Use Disorder) Counselor
4101YM0800XMental Health Counselor
5106H00000XMarriage & Family TherapistMT4212DC

General Provider Information

NPI Number : 1821576257
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE NICOLE BARKER LMFT, MCAP, IC-ADC
Provider Business Mailing Address
First Line : PO BOX 61421
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32236-1421
Country : US
Telephone Number : 904-891-5900
Fax Number :
Provider Business Practice Location Address
First Line : 6639 SOUTHPOINT PKWY STE 108
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32216-8042
Country : US
Telephone Number : 904-891-5900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2018
Last Update Date : 05/07/2024

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