Provider Demographics
NPI:1225543234
Name:BARNHART, TAMMY M (LSW, LADC)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:M
Last Name:BARNHART
Suffix:
Gender:F
Credentials:LSW, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 ACADEMY ST STE 3
Mailing Address - Street 2:
Mailing Address - City:PRESQUE ISLE
Mailing Address - State:ME
Mailing Address - Zip Code:04769-3183
Mailing Address - Country:US
Mailing Address - Phone:207-554-2352
Mailing Address - Fax:207-554-2351
Practice Address - Street 1:180 ACADEMY ST STE 2
Practice Address - Street 2:
Practice Address - City:PRESQUE ISLE
Practice Address - State:ME
Practice Address - Zip Code:04769-3183
Practice Address - Country:US
Practice Address - Phone:207-764-3319
Practice Address - Fax:207-768-5377
Is Sole Proprietor?:No
Enumeration Date:2017-12-13
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECAC5728101Y00000X
MELC7247101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor