Provider Demographics
NPI:1003110719
Name:BARNES, JAIME LYNN (LCPC)
Entity Type:Individual
Prefix:
First Name:JAIME
Middle Name:LYNN
Last Name:BARNES
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4545 CRAIN HWY
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:MD
Mailing Address - Zip Code:20695-1050
Mailing Address - Country:US
Mailing Address - Phone:301-609-6718
Mailing Address - Fax:301-609-6741
Practice Address - Street 1:4545 CRAIN HWY
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:MD
Practice Address - Zip Code:20695-1050
Practice Address - Country:US
Practice Address - Phone:301-609-6718
Practice Address - Fax:301-609-6741
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-10
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC3093101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD424194100Medicaid