Provider Demographics
NPI:1609973759
Name:BARKER, MELISSA (LPCC)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:BARKER
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3359 RATTLESNAKE RDG
Mailing Address - Street 2:
Mailing Address - City:OLIVE HILL
Mailing Address - State:KY
Mailing Address - Zip Code:41164-7971
Mailing Address - Country:US
Mailing Address - Phone:606-316-9755
Mailing Address - Fax:606-316-9755
Practice Address - Street 1:1544 WINCHESTER AVE STE 601
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-7929
Practice Address - Country:US
Practice Address - Phone:606-325-4091
Practice Address - Fax:606-325-4092
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-1167101YP2500X
KY3131104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY30610026Medicaid