Provider Demographics
NPI:1295065522
Name:BARRETT-MCNERNEY, HEIDI M (LCSW, CDCS, MAC)
Entity type:Individual
Prefix:MS
First Name:HEIDI
Middle Name:M
Last Name:BARRETT-MCNERNEY
Suffix:
Gender:F
Credentials:LCSW, CDCS, MAC
Other - Prefix:
Other - First Name:HEIDI
Other - Middle Name:M
Other - Last Name:BARRETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1994 E REZANOF DR
Mailing Address - Street 2:
Mailing Address - City:KODIAK
Mailing Address - State:AK
Mailing Address - Zip Code:99615-6952
Mailing Address - Country:US
Mailing Address - Phone:907-942-1986
Mailing Address - Fax:
Practice Address - Street 1:1944 E REZANOF DR
Practice Address - Street 2:
Practice Address - City:KODIAK
Practice Address - State:AK
Practice Address - Zip Code:99615-6601
Practice Address - Country:US
Practice Address - Phone:907-654-4575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-08
Last Update Date:2024-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK3374101YA0400X
AK1081071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK3374OtherCHEMICAL DEPENDENCY COUNSELOR SUPERVISOR
VA014987OtherMASTER ADDICTION COUNSELOR
AK108107OtherLICENSED CLINICAL SOCIAL WORKER