Provider Demographics
NPI:1437231669
Name:BARNETT, TARSHA ANN (LMSW, ACSW)
Entity Type:Individual
Prefix:MRS
First Name:TARSHA
Middle Name:ANN
Last Name:BARNETT
Suffix:
Gender:F
Credentials:LMSW, ACSW
Other - Prefix:MRS
Other - First Name:TARSHA
Other - Middle Name:ANN
Other - Last Name:MOTLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:2101 MARVA AVE
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49444-4516
Mailing Address - Country:US
Mailing Address - Phone:231-739-8068
Mailing Address - Fax:
Practice Address - Street 1:3535 PARK ST
Practice Address - Street 2:SUITE 101B
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49444-3736
Practice Address - Country:US
Practice Address - Phone:231-737-4444
Practice Address - Fax:231-737-5555
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801081556104100000X, 1041C0700X, 1041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered104100000XBehavioral Health & Social Service ProvidersSocial Worker
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
MITB081556OtherBCBSM
383016881/00620OtherPRIORITY HEALTH
8008971880Medicare UPIN
P11980001Medicare ID - Type Unspecified