Provider Demographics
NPI:1629743851
Name:BARRON, JACQUELYN ANN (LCSW)
Entity Type:Individual
Prefix:
First Name:JACQUELYN
Middle Name:ANN
Last Name:BARRON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JACQUELYN
Other - Middle Name:ANN
Other - Last Name:BENDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:125 BARRON ST
Mailing Address - Street 2:
Mailing Address - City:FRIEDENS
Mailing Address - State:PA
Mailing Address - Zip Code:15541-8427
Mailing Address - Country:US
Mailing Address - Phone:814-244-2348
Mailing Address - Fax:
Practice Address - Street 1:125 BARRON ST
Practice Address - Street 2:
Practice Address - City:FRIEDENS
Practice Address - State:PA
Practice Address - Zip Code:15541-8427
Practice Address - Country:US
Practice Address - Phone:814-244-2348
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-10
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0215171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical