Provider Demographics
NPI:1437122421
Name:BARNHARDT, LISA HURST (MSW)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:HURST
Last Name:BARNHARDT
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 1:3717 NATIONAL DR
Mailing Address - Street 2:STE 119
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-4067
Mailing Address - Country:US
Mailing Address - Phone:919-881-4197
Mailing Address - Fax:919-846-6189
Practice Address - Street 1:3717 NATIONAL DR
Practice Address - Street 2:STE 119
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-4067
Practice Address - Country:US
Practice Address - Phone:919-881-4197
Practice Address - Fax:919-846-6189
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC 0000921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC60335OtherBLUE CROSS & BLUE SHIELD