Healthcare Provider Details

I. General information

NPI: 1023227469
Provider Name (Legal Business Name): THOMAS F. BARRETT PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 10/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1030 N. CLARK ST. SUITE 303
CHICAGO IL
60610
US

IV. Provider business mailing address

1030 N. CLARK ST. SUITE 303
CHICAGO IL
60610
US

V. Phone/Fax

Practice location:
  • Phone: 312-513-6128
  • Fax:
Mailing address:
  • Phone: 312-513-6128
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code102L00000X
TaxonomyPsychoanalyst
License Number2831
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number2831
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: