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Provider Information for 1780313221


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IAN BARNES LCSW


Sex: Male

NPI: 1780313221
Last Updated: 2024-11-20
Certification Date: 2024-11-20

Details

NameValue
NPI1780313221
Enumeration Date2022-06-09
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 2700 N CENTRAL AVE STE 1050
PHOENIX, AZ 85004-1217
United States

Phone: 602-376-3353 | Fax:
 
Primary Practice Address 9051 W KELTON LN STE 13
PEORIA, AZ 85382-3533
United States

Phone: 623-815-5700 | Fax:623-815-5759
 
Secondary Practice Address(es)

618 S MADISON DR
TEMPE, AZ 85281-7248
United States

Phone: 480-784-1514 | Fax:
 

Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Other (non-Medicare)AZLCSW-18464State License
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 1041C0700X - Social Worker - Clinical