Healthcare Provider Details

I. General information

NPI: 1346020849
Provider Name (Legal Business Name): MARIAJOAQUINA BARRETT CSW-I
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2023
Last Update Date: 01/24/2024
Certification Date: 01/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

375 N STEPHANIE ST BLDG 21
HENDERSON NV
89014-8771
US

IV. Provider business mailing address

375 N STEPHANIE ST BLDG 21
HENDERSON NV
89014-8771
US

V. Phone/Fax

Practice location:
  • Phone: 702-799-9710
  • Fax: 702-799-9712
Mailing address:
  • Phone: 702-799-9710
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number7843-M
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberIC-2297
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: