Provider Demographics
NPI:1174879985
Name:BARKER, CINDY MARIE (MSW-CC)
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:MARIE
Last Name:BARKER
Suffix:
Gender:F
Credentials:MSW-CC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 509
Mailing Address - Street 2:
Mailing Address - City:PRESQUE ISLE
Mailing Address - State:ME
Mailing Address - Zip Code:04769-0509
Mailing Address - Country:US
Mailing Address - Phone:207-764-6825
Mailing Address - Fax:
Practice Address - Street 1:27 BIRDSEYE AVE
Practice Address - Street 2:
Practice Address - City:CARIBOU
Practice Address - State:ME
Practice Address - Zip Code:04736-1620
Practice Address - Country:US
Practice Address - Phone:207-492-1653
Practice Address - Fax:207-492-1633
Is Sole Proprietor?:No
Enumeration Date:2012-07-30
Last Update Date:2019-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMC13668104100000X
MELC157771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1174879985Medicaid