Provider Demographics
NPI:1639294549
Name:BARKER, JANE (LISW)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:
Last Name:BARKER
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 WHITWORTH CIRCLE
Mailing Address - Street 2:SUITE B
Mailing Address - City:SENECA
Mailing Address - State:SC
Mailing Address - Zip Code:29672-9432
Mailing Address - Country:US
Mailing Address - Phone:864-221-9150
Mailing Address - Fax:864-882-2712
Practice Address - Street 1:800 WHITWORTH CIRCLE
Practice Address - Street 2:SUITE B
Practice Address - City:SENECA
Practice Address - State:SC
Practice Address - Zip Code:29672-0000
Practice Address - Country:US
Practice Address - Phone:864-221-9150
Practice Address - Fax:864-882-2712
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC51081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical