Provider Demographics
NPI:1730227554
Name:BARNES, MARTHA (LPC-S)
Entity type:Individual
Prefix:
First Name:MARTHA
Middle Name:
Last Name:BARNES
Suffix:
Gender:F
Credentials:LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2558 DOUGLAS HYATT RD
Mailing Address - Street 2:
Mailing Address - City:HORTON
Mailing Address - State:AL
Mailing Address - Zip Code:35980-9004
Mailing Address - Country:US
Mailing Address - Phone:256-891-8172
Mailing Address - Fax:
Practice Address - Street 1:1909 COMMERCE AVE
Practice Address - Street 2:
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35055-6151
Practice Address - Country:US
Practice Address - Phone:256-434-4688
Practice Address - Fax:256-736-5638
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL242101YA0400X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51533350OtherBCBS
AL6230146OtherALL KIDS
AL6231146OtherALL KIDS PLUS