Provider Demographics
NPI:1033628821
Name:BARRETT, DIANN ROSE (BSW, CPST)
Entity Type:Individual
Prefix:
First Name:DIANN
Middle Name:ROSE
Last Name:BARRETT
Suffix:
Gender:F
Credentials:BSW, CPST
Other - Prefix:MS
Other - First Name:DIANN
Other - Middle Name:ROSE
Other - Last Name:BARRETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSW, CPST
Mailing Address - Street 1:16 W LONG ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-2815
Mailing Address - Country:US
Mailing Address - Phone:614-999-8148
Mailing Address - Fax:614-225-0988
Practice Address - Street 1:16 W LONG ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-2815
Practice Address - Country:US
Practice Address - Phone:614-999-8148
Practice Address - Fax:614-225-0988
Is Sole Proprietor?:No
Enumeration Date:2017-09-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator