1013089051 NPI number — MS. MARILOU BARRATT LCSW-C

Table of content: MS. MARILOU BARRATT LCSW-C (NPI 1013089051)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013089051 NPI number — MS. MARILOU BARRATT LCSW-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BARRATT
Provider First Name:
MARILOU
Provider Middle Name:
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1013089051
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/29/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10060 VISTA CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MYERSVILLE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21773-8138
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
240-818-8344
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10060 VISTA CT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MYERSVILLE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21773-8138
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
240-818-8344
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  04111 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 010010391 . This is a "INTEGRATED BEHAVIORAL HEA" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: QR55M . This is a "CAREFIRST BCBS OF MD" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: R5440001 . This is a "CAREFIRST BCBS-FED EMPLOY" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 4223346 . This is a "AETNA ID #" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: QR55 . This is a "MAGELLAN" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 17707 . This is a "CIGNA" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 181602YAZG . This is a "IND. PTAN" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 183417 . This is a "INC PTAN" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: R5440001 . This is a "CAREFIRST BLUE CHOICE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 324025 . This is a "MAMSI, ALLLIANCE, OPTIMUM" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 002258 . This is a "VALUEOPTIONS" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: PVPB122176 . This is a "AM PSYCH SERVICES" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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