Provider Demographics
NPI:1386302594
Name:BARNES, ALISHA MARIE (MS, LPC, CCTP-II)
Entity type:Individual
Prefix:
First Name:ALISHA
Middle Name:MARIE
Last Name:BARNES
Suffix:
Gender:F
Credentials:MS, LPC, CCTP-II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7138 DECATUR ST APT 5
Mailing Address - Street 2:
Mailing Address - City:NEW TRIPOLI
Mailing Address - State:PA
Mailing Address - Zip Code:18066-3860
Mailing Address - Country:US
Mailing Address - Phone:610-390-8395
Mailing Address - Fax:
Practice Address - Street 1:7138 DECATUR ST APT 5
Practice Address - Street 2:
Practice Address - City:NEW TRIPOLI
Practice Address - State:PA
Practice Address - Zip Code:18066-3860
Practice Address - Country:US
Practice Address - Phone:610-390-8395
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-05
Last Update Date:2021-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC012090101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional