Provider Demographics
NPI:1316938731
Name:BARNES, JONATHAN ALAN (PHD PSYCHOLOGIST)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:ALAN
Last Name:BARNES
Suffix:
Gender:M
Credentials:PHD PSYCHOLOGIST
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Mailing Address - Street 1:301 VIOLETA CIR
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27534-3245
Mailing Address - Country:US
Mailing Address - Phone:919-778-1251
Mailing Address - Fax:919-587-0282
Practice Address - Street 1:301 VIOLETA CIR
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-3245
Practice Address - Country:US
Practice Address - Phone:919-778-1251
Practice Address - Fax:919-587-0282
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC0826103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6000550Medicaid
NC03132OtherBLUE CROSS BLUE SHIELD
NC2812076A/JAMES ST.Medicare ID - Type Unspecified