Provider Demographics
NPI:1003055500
Name:BARRETT, RAYMOND (LPC, LMHC)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:
Last Name:BARRETT
Suffix:
Gender:M
Credentials:LPC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:261 S PEARL ST
Mailing Address - Street 2:
Mailing Address - City:CANANDAIGUA
Mailing Address - State:NY
Mailing Address - Zip Code:14424-1749
Mailing Address - Country:US
Mailing Address - Phone:585-857-6122
Mailing Address - Fax:585-905-3239
Practice Address - Street 1:514 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CANANDAIGUA
Practice Address - State:NY
Practice Address - Zip Code:14424-2246
Practice Address - Country:US
Practice Address - Phone:585-857-6122
Practice Address - Fax:585-905-3239
Is Sole Proprietor?:No
Enumeration Date:2009-02-07
Last Update Date:2014-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC006295101YP2500X
NC8823101YP2500X
NY005308101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional