Provider Demographics
NPI:1841379237
Name:BARKER-HART, MIKA (LICSW)
Entity Type:Individual
Prefix:MS
First Name:MIKA
Middle Name:
Last Name:BARKER-HART
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:184 PAINTER HILLS RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05753-8888
Mailing Address - Country:US
Mailing Address - Phone:802-388-1373
Mailing Address - Fax:
Practice Address - Street 1:10 MERCHANTS ROW
Practice Address - Street 2:
Practice Address - City:MIDDLEBURY
Practice Address - State:VT
Practice Address - Zip Code:05753-1421
Practice Address - Country:US
Practice Address - Phone:802-388-1373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT08900007881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1007739Medicaid
VT1007739Medicaid