Provider Demographics
NPI:1235373606
Name:BARNES, DANA JACKSON (BS, QMHCP)
Entity Type:Individual
Prefix:MRS
First Name:DANA
Middle Name:JACKSON
Last Name:BARNES
Suffix:
Gender:F
Credentials:BS, QMHCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5340 SEASPRAY LN
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27610-5781
Mailing Address - Country:US
Mailing Address - Phone:919-696-1772
Mailing Address - Fax:
Practice Address - Street 1:1616 RIVERKNOLL DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-4580
Practice Address - Country:US
Practice Address - Phone:919-212-3807
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-28
Last Update Date:2009-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility