MEDICARE: MS. TAMARA SHAREE BARNETT BS, MS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	101YM0800X	Mental Health Counselor
2	261QM0855X	Adolescent and Children Mental Health Clinic/Center
3	373H00000X	Day Training/Habilitation Specialist
4	104100000X	Social Worker

General Provider Information

NPI Number	:	1871147918
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TAMARA SHAREE BARNETT BS, MS

Provider Business Mailing Address
First Line	:	2402 PENNY CT
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46229-1453
Country	:	US
Telephone Number	:	317-590-6958
Fax Number	:

Provider Business Practice Location Address
First Line	:	2402 PENNY CT
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46229-1453
Country	:	US
Telephone Number	:	317-590-6958
Fax Number	:

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

Provider Enumeration Date	:	07/26/2019
Last Update Date	:	07/26/2019

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