Provider Demographics
NPI:1326502873
Name:BARRETT, MOLLY (MA, TLMHC, NCC)
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:
Last Name:BARRETT
Suffix:
Gender:F
Credentials:MA, TLMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:427 3RD ST
Mailing Address - Street 2:
Mailing Address - City:WASHBURN
Mailing Address - State:IA
Mailing Address - Zip Code:50702-6060
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3100 E AVE NW STE 105
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52405-2962
Practice Address - Country:US
Practice Address - Phone:800-531-4236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-29
Last Update Date:2019-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA094776101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health