Provider Demographics
NPI:1326690306
Name:BARNES LLMSW, RODNEY L (LLMSW, CAADC, ACSW)
Entity Type:Individual
Prefix:MR
First Name:RODNEY
Middle Name:L
Last Name:BARNES LLMSW
Suffix:
Gender:M
Credentials:LLMSW, CAADC, ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10100 HARPER AVE
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48213-3112
Mailing Address - Country:US
Mailing Address - Phone:313-921-9422
Mailing Address - Fax:313-571-9022
Practice Address - Street 1:10100 HARPER AVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48213-3112
Practice Address - Country:US
Practice Address - Phone:313-921-9422
Practice Address - Fax:313-571-9022
Is Sole Proprietor?:No
Enumeration Date:2019-07-10
Last Update Date:2019-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6802067047104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker