Provider Demographics
NPI:1417036922
Name:BARNHART, CARMEN (LAC)
Entity type:Individual
Prefix:
First Name:CARMEN
Middle Name:
Last Name:BARNHART
Suffix:
Gender:
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1705 3RD AVE NW
Mailing Address - Street 2:
Mailing Address - City:MANDAN
Mailing Address - State:ND
Mailing Address - Zip Code:58554-1846
Mailing Address - Country:US
Mailing Address - Phone:701-202-7924
Mailing Address - Fax:
Practice Address - Street 1:905 E INTERSTATE AVE
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58503-0549
Practice Address - Country:US
Practice Address - Phone:701-222-4673
Practice Address - Fax:701-328-8900
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1427101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
18759OtherBCBS