Provider Demographics
NPI:1437892965
Name:BARNES, JOSEPH WALLACE III (LCSW)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:WALLACE
Last Name:BARNES
Suffix:III
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6119 CASTELL DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-9705
Mailing Address - Country:US
Mailing Address - Phone:719-963-9570
Mailing Address - Fax:
Practice Address - Street 1:2500 MERIDIAN PKWY STE 300
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-5255
Practice Address - Country:US
Practice Address - Phone:919-443-1708
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-13
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCCO148441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical