Provider Demographics
NPI:1700650421
Name:BARNARD, MICHAEL JASON
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:JASON
Last Name:BARNARD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16675 NW 193RD TER
Mailing Address - Street 2:
Mailing Address - City:HIGH SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32643-8170
Mailing Address - Country:US
Mailing Address - Phone:813-395-3182
Mailing Address - Fax:
Practice Address - Street 1:16675 NW 193RD TER
Practice Address - Street 2:
Practice Address - City:HIGH SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32643-8170
Practice Address - Country:US
Practice Address - Phone:813-395-3182
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-13
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker