Provider Demographics
NPI:1235725540
Name:BARNETT, KAITLIN JESSICA BELL (LCSW)
Entity type:Individual
Prefix:MS
First Name:KAITLIN
Middle Name:JESSICA BELL
Last Name:BARNETT
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:KAITLIN
Other - Middle Name:JESSICA
Other - Last Name:BARNETT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6 WEDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:DELMAR
Mailing Address - State:NY
Mailing Address - Zip Code:12054-1324
Mailing Address - Country:US
Mailing Address - Phone:518-412-3285
Mailing Address - Fax:518-362-4760
Practice Address - Street 1:1 BURHANS PL
Practice Address - Street 2:
Practice Address - City:DELMAR
Practice Address - State:NY
Practice Address - Zip Code:12054-1201
Practice Address - Country:US
Practice Address - Phone:518-412-3285
Practice Address - Fax:518-362-4760
Is Sole Proprietor?:No
Enumeration Date:2020-12-21
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0985561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY08039154Medicaid