Betty A Barnette, LPC
Individual provider Active NPI Social Worker · Jackson, TN
NPI 1215178587 · NPPES record last updated Oct 25, 2011
Key facts
- NPI
- 1215178587
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- LPC1759 (TN)
- Practice address
- 45 Executive Dr
Jackson, TN 38305-2337 - Phone
- (731) 664-2083
- Fax
- (731) 664-1988
- NPI assigned
- Mar 17, 2009
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC1759 | TN | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mental Health Centers & Clinics of Tennessee | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | LPC1759 | TN | Yes |
Addresses
Primary practice location
45 Executive Dr
Jackson, TN 38305-2337
Mailing address
45 Executive Dr
Jackson, TN 38305-2337
Phone (731) 664-2083
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1512073 | Medicaid | TN | |
| IB4222313 | Other | TN | BCBS |
Other providers in Jackson, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 25, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.