Provider Demographics
NPI:1982822474
Name:BARNES, EDWIN (EDD)
Entity Type:Individual
Prefix:DR
First Name:EDWIN
Middle Name:
Last Name:BARNES
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 CANON RDG
Mailing Address - Street 2:
Mailing Address - City:FORT THOMAS
Mailing Address - State:KY
Mailing Address - Zip Code:41075-2059
Mailing Address - Country:US
Mailing Address - Phone:859-630-6635
Mailing Address - Fax:513-357-4709
Practice Address - Street 1:9900 CINCINNATI COLUMBUS RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45241-1209
Practice Address - Country:US
Practice Address - Phone:513-779-9955
Practice Address - Fax:513-779-9955
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2009-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC. 0008436101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional