Provider Demographics
NPI:1699255208
Name:BARNAUD, CECILY JO (LCSW)
Entity type:Individual
Prefix:
First Name:CECILY
Middle Name:JO
Last Name:BARNAUD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:CECILY
Other - Middle Name:JO
Other - Last Name:SWENSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:115 N 7TH ST STE 6
Mailing Address - Street 2:
Mailing Address - City:SPEARFISH
Mailing Address - State:SD
Mailing Address - Zip Code:57783-2710
Mailing Address - Country:US
Mailing Address - Phone:605-645-0100
Mailing Address - Fax:605-717-1009
Practice Address - Street 1:115 N 7TH ST STE 6
Practice Address - Street 2:
Practice Address - City:SPEARFISH
Practice Address - State:SD
Practice Address - Zip Code:57783-2710
Practice Address - Country:US
Practice Address - Phone:605-645-0100
Practice Address - Fax:605-717-1009
Is Sole Proprietor?:No
Enumeration Date:2018-08-14
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD6229104100000X, 1041S0200X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD3008004Medicaid