Provider Demographics
NPI:1932967197
Name:BARNES, CERRIE (CEO)
Entity Type:Individual
Prefix:
First Name:CERRIE
Middle Name:
Last Name:BARNES
Suffix:
Gender:F
Credentials:CEO
Other - Prefix:
Other - First Name:CERRIE
Other - Middle Name:
Other - Last Name:BARNES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FOUNDER CEO
Mailing Address - Street 1:4750 CROSSCREEK DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43232-6191
Mailing Address - Country:US
Mailing Address - Phone:330-786-6768
Mailing Address - Fax:
Practice Address - Street 1:1495 MORSE RD STE B
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-6478
Practice Address - Country:US
Practice Address - Phone:330-786-6768
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator