Provider Demographics
NPI:1326189390
Name:WALDNER, BARBARA HARROD (LCSW)
Entity type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:HARROD
Last Name:WALDNER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3121 WALL ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40513-1711
Mailing Address - Country:US
Mailing Address - Phone:859-223-9345
Mailing Address - Fax:859-223-8440
Practice Address - Street 1:3121 WALL ST
Practice Address - Street 2:SUITE 100
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40513-1711
Practice Address - Country:US
Practice Address - Phone:859-223-9345
Practice Address - Fax:859-223-8440
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYLCSW 4381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYR61833Medicare UPIN
KYCSW0050Medicare ID - Type Unspecified