Provider Demographics
NPI:1023541281
Name:BARKER, KIMBERLY ELIZABETH (MA, LSW)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:ELIZABETH
Last Name:BARKER
Suffix:
Gender:F
Credentials:MA, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RR 2 BOX 433
Mailing Address - Street 2:9 WHITE OAK LANE
Mailing Address - City:DELBARTON
Mailing Address - State:WV
Mailing Address - Zip Code:25670-9775
Mailing Address - Country:US
Mailing Address - Phone:304-475-5249
Mailing Address - Fax:304-475-5249
Practice Address - Street 1:RR 2 BOX 433
Practice Address - Street 2:9 WHITE OAK LANE
Practice Address - City:DELBARTON
Practice Address - State:WV
Practice Address - Zip Code:25670-9775
Practice Address - Country:US
Practice Address - Phone:304-475-5249
Practice Address - Fax:304-475-5249
Is Sole Proprietor?:No
Enumeration Date:2017-04-05
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVAP00941715104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker