Provider Demographics
NPI:1073807244
Name:BARRETT, KIMBERLY LYNN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:LYNN
Last Name:BARRETT
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 1:3181 LAKE BROOK BLVD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909-1143
Mailing Address - Country:US
Mailing Address - Phone:865-321-1177
Mailing Address - Fax:
Practice Address - Street 1:4928 HOMBERG DR
Practice Address - Street 2:SUITE A-4
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-5100
Practice Address - Country:US
Practice Address - Phone:865-321-1177
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-06
Last Update Date:2015-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD128531041C0700X
TN5805101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical