Provider Demographics
NPI:1730219254
Name:MCDERMID, BARBARA ANN (PHD, ARNP, LCSW)
Entity type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:ANN
Last Name:MCDERMID
Suffix:
Gender:F
Credentials:PHD, ARNP, LCSW
Other - Prefix:DR
Other - First Name:BARBARA
Other - Middle Name:ANN
Other - Last Name:MCDERMID
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ARNP, LCSW
Mailing Address - Street 1:2475 GARRISON AVE
Mailing Address - Street 2:
Mailing Address - City:PORT ST JOE
Mailing Address - State:FL
Mailing Address - Zip Code:32456-5265
Mailing Address - Country:US
Mailing Address - Phone:850-227-1276
Mailing Address - Fax:850-227-1766
Practice Address - Street 1:2475 GARRISON AVE
Practice Address - Street 2:
Practice Address - City:PORT ST JOE
Practice Address - State:FL
Practice Address - Zip Code:32456-5265
Practice Address - Country:US
Practice Address - Phone:850-227-1276
Practice Address - Fax:850-227-1766
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2008-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 73221041C0700X
FLARNP 9203658363LC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No363LC1500XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ054QOtherBLUE CROSS BLUE SHIELD AS LCSW
FL308654200Medicaid
FL308654200Medicaid