Provider Demographics
NPI:1124176334
Name:BARR, MARTHA KATHERINE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:MARTHA
Middle Name:KATHERINE
Last Name:BARR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:KATIE
Other - Middle Name:
Other - Last Name:BARR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:1465 CHESTNUT AVE
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-2610
Mailing Address - Country:US
Mailing Address - Phone:760-729-4999
Mailing Address - Fax:760-720-0021
Practice Address - Street 1:3150 EL CAMINO REAL STE E
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-2110
Practice Address - Country:US
Practice Address - Phone:760-519-2555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS209131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical