Provider Demographics
NPI:1043612682
Name:BARNES, EMILY (LCSW)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:BARNES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:KIME
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:40 WOODRUFF AVE
Mailing Address - Street 2:APT. 102
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-1179
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1310 ROCKAWAY PKWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11236-2339
Practice Address - Country:US
Practice Address - Phone:718-272-3300
Practice Address - Fax:718-927-1801
Is Sole Proprietor?:No
Enumeration Date:2014-09-25
Last Update Date:2017-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY72 087473104100000X
NY0854551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker