Provider Demographics
NPI:1255773602
Name:BARNES, ROSE (MFT)
Entity type:Individual
Prefix:
First Name:ROSE
Middle Name:
Last Name:BARNES
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7B LEDGEBROOK DR
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD CENTER
Mailing Address - State:CT
Mailing Address - Zip Code:06250-1664
Mailing Address - Country:US
Mailing Address - Phone:860-456-0038
Mailing Address - Fax:860-456-8765
Practice Address - Street 1:101 WATER ST
Practice Address - Street 2:
Practice Address - City:NORWICH
Practice Address - State:CT
Practice Address - Zip Code:06360-5730
Practice Address - Country:US
Practice Address - Phone:860-425-5258
Practice Address - Fax:203-397-9077
Is Sole Proprietor?:No
Enumeration Date:2013-07-26
Last Update Date:2017-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health