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General NPI Number Information
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NPI Number | 1912384371
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Entity Type | Individual
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Provider Name | MANDY KIDWELL BARRETT PHD, NCC, LPC, RPT
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Gender | Female
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Dates
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Enumeration Date | 05/05/2015
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Last Update Date | 09/25/2019
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Provider Practice Location Address
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Address Line | 8700 MANCHACA RD STE 801
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City | AUSTIN
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State | TX
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Zip | 78748-5379
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Country | US
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Telephone | 504-609-9997
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Fax |
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Provider Business Mailing Address
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Address Line | 2501 THORNTON RD APT 3203
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City | AUSTIN
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State | TX
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Zip | 78704-5596
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Country | US
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Telephone | 504-609-9997
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 6185
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 82047
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License Number State | TX
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