1235725540 NPI number — MS. KAITLIN JESSICA BELL BARNETT LCSW

Table of content: MS. KAITLIN JESSICA BELL BARNETT LCSW (NPI 1235725540)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235725540 NPI number — MS. KAITLIN JESSICA BELL BARNETT LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BARNETT
Provider First Name:
KAITLIN
Provider Middle Name:
JESSICA BELL
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BARNETT
Provider Other First Name:
KAITLIN
Provider Other Middle Name:
JESSICA
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1235725540
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/27/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6 WEDGEWOOD DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DELMAR
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
12054-1324
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
518-412-3285
Provider Business Mailing Address Fax Number:
518-362-4760

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 BURHANS PL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DELMAR
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12054-1201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-412-3285
Provider Business Practice Location Address Fax Number:
518-362-4760
Provider Enumeration Date:
12/21/2020

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  098556 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 08039154 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




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