Provider Demographics
NPI:1841963311
Name:BARNETT, EDDIE (PLPC)
Entity type:Individual
Prefix:
First Name:EDDIE
Middle Name:
Last Name:BARNETT
Suffix:
Gender:M
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10610 N MARSH AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64157-7757
Mailing Address - Country:US
Mailing Address - Phone:816-809-3755
Mailing Address - Fax:
Practice Address - Street 1:9601 NE BARRY RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64158-7633
Practice Address - Country:US
Practice Address - Phone:816-895-7775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-29
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS3660101YM0800X
MO2020025030101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health