Provider Demographics
NPI:1780244889
Name:BARNES, KEISHA (LICSW)
Entity type:Individual
Prefix:MS
First Name:KEISHA
Middle Name:
Last Name:BARNES
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1430 GADSDEN HWY STE 116-595
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35235-3103
Mailing Address - Country:US
Mailing Address - Phone:205-616-1147
Mailing Address - Fax:
Practice Address - Street 1:1430 GADSDEN HWY STE 116-595
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35235-3103
Practice Address - Country:US
Practice Address - Phone:205-616-1147
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-19
Last Update Date:2020-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4371C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical