Provider Demographics
NPI:1023443611
Name:BARNES, DAVID LEE (CAC-AD)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:LEE
Last Name:BARNES
Suffix:
Gender:M
Credentials:CAC-AD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12615 FARNELL DR
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20906-3873
Mailing Address - Country:US
Mailing Address - Phone:301-906-0791
Mailing Address - Fax:
Practice Address - Street 1:12615 FARNELL DR
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20906-3873
Practice Address - Country:US
Practice Address - Phone:301-906-0791
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-13
Last Update Date:2013-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDAC0968101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)