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NPI Code Detail

MEDICARE: MRS. KRISTINA MICHELLE BARRETT LCSW

MEDICARE: MRS. KRISTINA MICHELLE BARRETT LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor34004210AIN

General Provider Information

NPI Number : 1144387689
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KRISTINA MICHELLE BARRETT LCSW
Provider Business Mailing Address
First Line : 230 E MAPLE ST
Second Line :
City : JEFFERSONVILLE
State : IN
Zip : 47130-3420
Country : US
Telephone Number : 502-817-4473
Fax Number :
Provider Business Practice Location Address
First Line : 230 E MAPLE ST
Second Line :
City : JEFFERSONVILLE
State : IN
Zip : 47130-3420
Country : US
Telephone Number : 502-817-4473
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/03/2007
Last Update Date : 07/08/2007

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