Provider Demographics
NPI:1346304383
Name:BARKER, REBECCA FARLOWE (MSW)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:FARLOWE
Last Name:BARKER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 MAGNOLIA VIEW LN
Mailing Address - Street 2:
Mailing Address - City:ROLESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27571-9324
Mailing Address - Country:US
Mailing Address - Phone:919-633-7230
Mailing Address - Fax:919-556-3349
Practice Address - Street 1:5850 FARINGDON PL
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-3930
Practice Address - Country:US
Practice Address - Phone:919-633-7230
Practice Address - Fax:919-556-3449
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2015-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC005618104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6106620Medicaid