Provider Demographics
NPI:1700424041
Name:BARNES, JOSHUA AARON (JD, LCSW)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:AARON
Last Name:BARNES
Suffix:
Gender:M
Credentials:JD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2023 SANDPOINT WEST DR
Mailing Address - Street 2:
Mailing Address - City:SANDPOINT
Mailing Address - State:ID
Mailing Address - Zip Code:83864-7304
Mailing Address - Country:US
Mailing Address - Phone:208-265-5412
Mailing Address - Fax:208-263-2278
Practice Address - Street 1:2023 SANDPOINT WEST DR
Practice Address - Street 2:
Practice Address - City:SANDPOINT
Practice Address - State:ID
Practice Address - Zip Code:83864-7304
Practice Address - Country:US
Practice Address - Phone:208-265-5412
Practice Address - Fax:208-263-2278
Is Sole Proprietor?:No
Enumeration Date:2019-12-17
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDMSW-39263104100000X
IDLCSW424541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker