Provider Demographics
NPI:1528059516
Name:BARNHART-GRAY, CLOYE ANITA (LCSW)
Entity type:Individual
Prefix:MS
First Name:CLOYE
Middle Name:ANITA
Last Name:BARNHART-GRAY
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 1:21205 HYW 22
Mailing Address - Street 2:
Mailing Address - City:MC KENZIE
Mailing Address - State:TN
Mailing Address - Zip Code:38201-1649
Mailing Address - Country:US
Mailing Address - Phone:731-352-1401
Mailing Address - Fax:731-352-1402
Practice Address - Street 1:21205 HYW 22
Practice Address - Street 2:
Practice Address - City:MC KENZIE
Practice Address - State:TN
Practice Address - Zip Code:38201-1649
Practice Address - Country:US
Practice Address - Phone:731-352-1401
Practice Address - Fax:731-352-1402
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2015-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLSW00000044461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1507746Medicaid
TN103I805070Medicare PIN
TN3380640OtherMEDICAID GROUP
TN3380640OtherMEDICARE GROUP NUMBER