Provider Demographics
NPI:1689920167
Name:BARNES, CAROLYN PATRICIA (PSY D)
Entity Type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:PATRICIA
Last Name:BARNES
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:MRS
Other - First Name:CAROLYN
Other - Middle Name:PATRICIA
Other - Last Name:HOFSTETTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1090 FOUNDERS BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-6163
Mailing Address - Country:US
Mailing Address - Phone:706-548-8697
Mailing Address - Fax:706-548-8698
Practice Address - Street 1:1090 FOUNDERS BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-6163
Practice Address - Country:US
Practice Address - Phone:706-548-8697
Practice Address - Fax:706-548-8698
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-02
Last Update Date:2012-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY003585103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical