MEDICARE: MS. MARY CATHLEEN BARRRETT M.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	E.0000087	OH
2	101YM0800X	Mental Health Counselor	E.0000087	OH

General Provider Information

NPI Number	:	1013075571
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARY CATHLEEN BARRRETT M.A.

Provider Business Mailing Address
First Line	:	5057 RACE RD NW
Second Line	:
City	:	DOVER
State	:	OH
Zip	:	44622-7107
Country	:	US
Telephone Number	:	330-343-8656
Fax Number	:

Provider Business Practice Location Address
First Line	:	1303 W MAPLE ST STE 102
Second Line	:
City	:	NORTH CANTON
State	:	OH
Zip	:	44720-2858
Country	:	US
Telephone Number	:	330-896-8910
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/05/2006
Last Update Date	:	05/18/2011

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