Provider Demographics
NPI:1609647817
Name:BARNEY, BRETT
Entity Type:Individual
Prefix:
First Name:BRETT
Middle Name:
Last Name:BARNEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10456 MASTIN ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66212-5701
Mailing Address - Country:US
Mailing Address - Phone:913-735-3393
Mailing Address - Fax:913-355-0215
Practice Address - Street 1:10456 MASTIN ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66212-5701
Practice Address - Country:US
Practice Address - Phone:913-735-3393
Practice Address - Fax:913-355-0215
Is Sole Proprietor?:No
Enumeration Date:2024-01-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS24-322260106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician