MEDICARE: SANDRA LEE BARRETT LCSW-C

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
1	1041C0700X	Clinical Social Worker	06466	MD
2	1041C0700X	Clinical Social Worker	0904002658	VA
3	1041C0700X	Clinical Social Worker	LI50077695	DC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1487707535
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDRA LEE BARRETT LCSW-C

Provider Business Mailing Address
First Line	:	8427 SILVERDALE CT
Second Line	:
City	:	LORTON
State	:	VA
Zip	:	22079-3065
Country	:	US
Telephone Number	:	301-316-4176
Fax Number	:	703-646-4368

Provider Business Practice Location Address
First Line	:	4400 STAMP RD
Second Line	:	306
City	:	MARLOW HEIGHTS
State	:	MD
Zip	:	20748-6716
Country	:	US
Telephone Number	:	301-316-4176
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/20/2007
Last Update Date	:	07/22/2011

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