Provider Demographics
NPI:1619494705
Name:BARNES, JOSHUA (MPS, CASAC)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:BARNES
Suffix:
Gender:M
Credentials:MPS, CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1910 ARTHUR AVE FL 7
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457-6305
Mailing Address - Country:US
Mailing Address - Phone:718-583-5150
Mailing Address - Fax:
Practice Address - Street 1:1910 ARTHUR AVE FL 7
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-6305
Practice Address - Country:US
Practice Address - Phone:718-583-5150
Practice Address - Fax:718-731-2453
Is Sole Proprietor?:No
Enumeration Date:2017-08-29
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY098582657Medicaid
NY098582657Medicaid