Healthcare Provider Details

I. General information

NPI: 1417400847
Provider Name (Legal Business Name): MARY BARRETT LPC, LCPC, LCPAT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2016
Last Update Date: 03/09/2021
Certification Date: 08/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 N IRVING ST
ARLINGTON VA
22201-1049
US

IV. Provider business mailing address

215 N IRVING ST
ARLINGTON VA
22201-1049
US

V. Phone/Fax

Practice location:
  • Phone: 703-628-2749
  • Fax:
Mailing address:
  • Phone: 703-628-2749
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPRC14982
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0701008027
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLC7670
License Number StateMD
# 4
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License NumberLC7670
License Number StateMD
# 5
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLC7670
License Number StateMD
# 6
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPRC14982
License Number StateDC
# 7
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License NumberPRC14982
License Number StateDC
# 8
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number0701008027
License Number StateVA
# 9
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License NumberATG216
License Number StateMD
# 10
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701008027
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: