Provider Demographics
NPI:1801633474
Name:BARNER, NICKAYLYNN (LPC-A)
Entity type:Individual
Prefix:
First Name:NICKAYLYNN
Middle Name:
Last Name:BARNER
Suffix:
Gender:F
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16790 MAMMOTH SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095-5488
Mailing Address - Country:US
Mailing Address - Phone:901-503-7145
Mailing Address - Fax:
Practice Address - Street 1:11301 FALLBROOK DR STE 300
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77065-4272
Practice Address - Country:US
Practice Address - Phone:281-305-1578
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-11
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX95391101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional