Provider Demographics
NPI:1962731141
Name:BARNES, EBONIE (MSCP, LMHC)
Entity type:Individual
Prefix:MRS
First Name:EBONIE
Middle Name:
Last Name:BARNES
Suffix:
Gender:F
Credentials:MSCP, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3307 BENSON PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32829-7330
Mailing Address - Country:US
Mailing Address - Phone:407-536-9050
Mailing Address - Fax:
Practice Address - Street 1:3307 BENSON PARK BLVD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32829-7330
Practice Address - Country:US
Practice Address - Phone:407-536-9050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-16
Last Update Date:2013-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health