Healthcare Provider Details

I. General information

NPI: 1013089051
Provider Name (Legal Business Name): MARILOU BARRATT LCSW-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 10/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10060 VISTA CT
MYERSVILLE MD
21773-8138
US

IV. Provider business mailing address

10060 VISTA CT
MYERSVILLE MD
21773-8138
US

V. Phone/Fax

Practice location:
  • Phone: 240-818-8344
  • Fax:
Mailing address:
  • Phone: 240-818-8344
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number04111
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: