Basic Information
Provider Information
NPI: 1174907455
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BARNES
FirstName: TOMESIA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MSW, LCSW-A
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6770 COBBLE CREEK RD APT 1B
Address2:  
City: WHITSETT
State: NC
PostalCode: 273778771
CountryCode: US
TelephoneNumber: 9102612135
FaxNumber:  
Practice Location
Address1: 508 FULTON ST
Address2:  
City: DURHAM
State: NC
PostalCode: 277053875
CountryCode: US
TelephoneNumber: 9192860411
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/16/2015
LastUpdateDate: 07/16/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700XP009589NCY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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