Provider Demographics
NPI:1063851145
Name:BAREFIELD, KRISTEN L (MSSA-LISW)
Entity Type:Individual
Prefix:MS
First Name:KRISTEN
Middle Name:L
Last Name:BAREFIELD
Suffix:
Gender:F
Credentials:MSSA-LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 E PARK AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:COLUMBIANA
Mailing Address - State:OH
Mailing Address - Zip Code:44408-1351
Mailing Address - Country:US
Mailing Address - Phone:330-257-7547
Mailing Address - Fax:330-726-9031
Practice Address - Street 1:9 E PARK AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:COLUMBIANA
Practice Address - State:OH
Practice Address - Zip Code:44408-1351
Practice Address - Country:US
Practice Address - Phone:330-257-7547
Practice Address - Fax:330-726-9031
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-21
Last Update Date:2017-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS0800065104100000X
OHI 1501217104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0174727Medicaid
OHH413221Medicare PIN