Provider Demographics
NPI:1972917144
Name:BARNETT, JASON ALAN (LCSWA)
Entity type:Individual
Prefix:MR
First Name:JASON
Middle Name:ALAN
Last Name:BARNETT
Suffix:
Gender:M
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:542 WILLIAMSON RD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-8193
Mailing Address - Country:US
Mailing Address - Phone:704-660-6854
Mailing Address - Fax:704-662-0866
Practice Address - Street 1:542 WILLIAMSON RD
Practice Address - Street 2:SUITE 6
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-8193
Practice Address - Country:US
Practice Address - Phone:704-660-6854
Practice Address - Fax:704-662-0866
Is Sole Proprietor?:No
Enumeration Date:2014-06-16
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0088251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical