Provider Demographics
NPI:1376310458
Name:BARNETT, KIMBERLY CARSCADDON (LCMHCA A17316)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:CARSCADDON
Last Name:BARNETT
Suffix:
Gender:F
Credentials:LCMHCA A17316
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2555 COLD SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-8004
Mailing Address - Country:US
Mailing Address - Phone:980-333-8565
Mailing Address - Fax:
Practice Address - Street 1:925 BRADLEY ST NE
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-0911
Practice Address - Country:US
Practice Address - Phone:704-360-3637
Practice Address - Fax:704-200-9829
Is Sole Proprietor?:No
Enumeration Date:2023-12-07
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA17316101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health