Provider Demographics
NPI:1861684805
Name:BARNES, WANDA MARIE (LCSW-C)
Entity Type:Individual
Prefix:MRS
First Name:WANDA
Middle Name:MARIE
Last Name:BARNES
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:WANDA
Other - Middle Name:MARIE
Other - Last Name:BLEDSOE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6045 SOLOMONS ISLAND RD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20639-8876
Mailing Address - Country:US
Mailing Address - Phone:410-257-5200
Mailing Address - Fax:410-257-2442
Practice Address - Street 1:6045 SOLOMONS ISLAND RD
Practice Address - Street 2:
Practice Address - City:HUNTINGTOWN
Practice Address - State:MD
Practice Address - Zip Code:20639-8876
Practice Address - Country:US
Practice Address - Phone:410-257-5200
Practice Address - Fax:410-257-2442
Is Sole Proprietor?:No
Enumeration Date:2007-08-14
Last Update Date:2009-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD149301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical