Provider Demographics
NPI:1871685693
Name:BARNARD, KATHIE BURRIDGE (LICSW)
Entity Type:Individual
Prefix:MS
First Name:KATHIE
Middle Name:BURRIDGE
Last Name:BARNARD
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 1:83 HIGHLAND ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH EASTON
Mailing Address - State:MA
Mailing Address - Zip Code:02375-1306
Mailing Address - Country:US
Mailing Address - Phone:508-238-8474
Mailing Address - Fax:
Practice Address - Street 1:841 MAIN ST
Practice Address - Street 2:SUITE 2
Practice Address - City:WALPOLE
Practice Address - State:MA
Practice Address - Zip Code:02081-2997
Practice Address - Country:US
Practice Address - Phone:508-660-6658
Practice Address - Fax:508-660-6658
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
MASW 105830-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health