Provider Demographics
NPI:1114080710
Name:MARILOU BARRATT PC
Entity Type:Organization
Organization Name:MARILOU BARRATT PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MARILOU
Authorized Official - Middle Name:
Authorized Official - Last Name:BARRATT
Authorized Official - Suffix:
Authorized Official - Credentials:LCSWC
Authorized Official - Phone:301-766-0041
Mailing Address - Street 1:10060 VISTA COURT
Mailing Address - Street 2:
Mailing Address - City:MYERSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21773-8138
Mailing Address - Country:US
Mailing Address - Phone:301-766-0041
Mailing Address - Fax:301-766-0041
Practice Address - Street 1:10060 VISTA CT
Practice Address - Street 2:
Practice Address - City:MYERSVIILE
Practice Address - State:MD
Practice Address - Zip Code:21773-8138
Practice Address - Country:US
Practice Address - Phone:240-818-8344
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD041111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty