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
Certification Date: 2024-11-20
Details
Name | Value | ||||||||
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NPI | 1780313221 | ||||||||
Enumeration Date | 2022-06-09 | ||||||||
NPI Type | NPI-1 Individual | ||||||||
Sole Proprietor | NO | ||||||||
Status | Active | ||||||||
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 | ||||||||
Health Information Exchange |
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