Provider Demographics
NPI:1194164798
Name:BARNETT, MARY MILANO (LCSWA)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:MILANO
Last Name:BARNETT
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5617 FAIRVIEW ROAD
Mailing Address - Street 2:UNIT #3
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28209-5602
Mailing Address - Country:US
Mailing Address - Phone:704-564-8965
Mailing Address - Fax:
Practice Address - Street 1:5617 FAIRVIEW RD
Practice Address - Street 2:UNIT #3
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28209-3691
Practice Address - Country:US
Practice Address - Phone:704-564-8965
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-18
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0084151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical