MEDICARE: ABIGAIL ELIZABETH BARNES

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	101YP2500X	Professional Counselor
2	101YP2500X	Professional Counselor	APC009320	GA

General Provider Information

NPI Number	:	1902585391
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABIGAIL ELIZABETH BARNES

Provider Business Mailing Address
First Line	:	6425 POWERS FERRY RD NORTHWEST #300
Second Line	:
City	:	SANDY SPRINGS
State	:	GA
Zip	:	30339
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6425 POWERS FERRY RD NW #300
Second Line	:
City	:	SANDY SPRINGS
State	:	GA
Zip	:	30339
Country	:	US
Telephone Number	:	770-570-0036
Fax Number	:

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

Provider Enumeration Date	:	07/13/2023
Last Update Date	:	10/06/2023

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