Provider Demographics
NPI:1609948595
Name:BARNES, LEAH CHRISTINE (LCMHC)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:CHRISTINE
Last Name:BARNES
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:LEAH
Other - Middle Name:CHRISTINE
Other - Last Name:WITT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:4052 ANCESTRY CIR
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28104-7601
Mailing Address - Country:US
Mailing Address - Phone:904-803-3350
Mailing Address - Fax:
Practice Address - Street 1:4052 ANCESTRY CIR
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28104-7601
Practice Address - Country:US
Practice Address - Phone:904-803-3350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10371101YM0800X
FLMH 9143101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL768736200Medicaid