Provider Demographics
NPI:1124677562
Name:BARNETT, DEBRA HACK (LMSW)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:HACK
Last Name:BARNETT
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:767B RICHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-5737
Mailing Address - Country:US
Mailing Address - Phone:225-892-5873
Mailing Address - Fax:
Practice Address - Street 1:8706 JEFFERSON HWY STE A
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-2233
Practice Address - Country:US
Practice Address - Phone:225-926-9706
Practice Address - Fax:225-926-9708
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-09
Last Update Date:2021-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA149051041C0700X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty