MEDICARE: ALYSSA NICOLE ROGERS BARKLEY 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	101Y00000X	Counselor
2	101YA0400X	Addiction (Substance Use Disorder) Counselor
3	101YM0800X	Mental Health Counselor
4	1041C0700X	Clinical Social Worker	LCSW74357	CA

General Provider Information

NPI Number	:	1891943668
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALYSSA NICOLE ROGERS BARKLEY LCSW

Provider Business Mailing Address
First Line	:	800 NIBLICK RD
Second Line	:
City	:	PASO ROBLES
State	:	CA
Zip	:	93446-4858
Country	:	US
Telephone Number	:	805-769-1700
Fax Number	:

Provider Business Practice Location Address
First Line	:	800 NIBLICK RD
Second Line	:
City	:	PASO ROBLES
State	:	CA
Zip	:	93446-4858
Country	:	US
Telephone Number	:	805-769-1700
Fax Number	:

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

Provider Enumeration Date	:	09/04/2008
Last Update Date	:	08/26/2019

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