Provider Demographics
NPI:1235514670
Name:BARNES, CATESSA TOMAS (LSW)
Entity Type:Individual
Prefix:MS
First Name:CATESSA
Middle Name:TOMAS
Last Name:BARNES
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 DUPONT WAY APT 2
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-4623
Mailing Address - Country:US
Mailing Address - Phone:502-395-0459
Mailing Address - Fax:
Practice Address - Street 1:4010 DUPONT CIR STE 582
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4888
Practice Address - Country:US
Practice Address - Phone:502-395-0459
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-28
Last Update Date:2015-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-3821104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker