Provider Demographics
NPI:1285628362
Name:BARRETT, PAUL T
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:T
Last Name:BARRETT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8333
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28814-8333
Mailing Address - Country:US
Mailing Address - Phone:828-545-7776
Mailing Address - Fax:828-658-0361
Practice Address - Street 1:1011 TUNNEL RD STE 240
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28805-2060
Practice Address - Country:US
Practice Address - Phone:828-545-7776
Practice Address - Fax:828-658-0361
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-06
Last Update Date:2020-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2796103G00000X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC045VAOtherBCBSNC
2820354BOtherMEDICARE PTAN
NC6000831Medicaid
NC045VAOtherBCBSNC