| Carina Barker Clinical Practice Llc | |
|
2207 E 5th Avenue Superior WI 54880 | |
| (218) 590-0620 | |
| Not Available |
| Full Name | Carina Barker Clinical Practice Llc |
|---|---|
| Speciality | Social Worker |
| Location | 2207 E 5th Avenue, Superior, Wisconsin |
| Authorized Official Name and Position | Carina L Barker (OWNER) |
| Authorized Official Contact | 2185900620 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carina Barker Clinical Practice Llc 1727 Logan Ave Superior WI 54880-2316 Ph: (218) 590-0620 | Carina Barker Clinical Practice Llc 2207 E 5th Avenue Superior WI 54880 Ph: (218) 590-0620 |
| NPI Number | 1174197909 |
|---|---|
| Provider Enumeration Date | 05/17/2021 |
| Last Update Date | 08/23/2024 |
| Certification Date | 08/23/2024 |
| Medicare PECOS PAC ID | 4880084102 |
|---|---|
| Medicare Enrollment ID | O20211201000181 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174197909 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Carina Lisa Barker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417907387 PECOS PAC ID: 5092766105 Enrollment ID: I20211201000308 |
| Provider Name | Jennifer L Hodgson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1578638201 PECOS PAC ID: 1456794270 Enrollment ID: I20240208003397 |
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