Healthcare Provider Details

I. General information

NPI: 1669605671
Provider Name (Legal Business Name): MONICA BARRETT LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2009
Last Update Date: 07/01/2021
Certification Date: 07/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3228 SYDENHAM ST
FAIRFAX VA
22031-4844
US

IV. Provider business mailing address

PO BOX 2846
MERRIFIELD VA
22116-1846
US

V. Phone/Fax

Practice location:
  • Phone: 662-202-4876
  • Fax:
Mailing address:
  • Phone: 662-202-4876
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License NumberPPS-0602534
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701004474
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: