Provider Demographics
NPI:1033453006
Name:BARNES, BRANDY (LCSW)
Entity Type:Individual
Prefix:
First Name:BRANDY
Middle Name:
Last Name:BARNES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3610 BANBURY DR APT 1D
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92505-1836
Mailing Address - Country:US
Mailing Address - Phone:714-588-3927
Mailing Address - Fax:
Practice Address - Street 1:357 W 2ND ST STE 3
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92401-1803
Practice Address - Country:US
Practice Address - Phone:909-936-3888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-15
Last Update Date:2020-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool