Provider Demographics
NPI:1346005816
Name:BAREFOOT, MATTHEW (MA, LPC)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:BAREFOOT
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 N WASHINGTON ST STE 100
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22046-3538
Mailing Address - Country:US
Mailing Address - Phone:704-451-8477
Mailing Address - Fax:
Practice Address - Street 1:520 N WASHINGTON ST STE 100
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046-3538
Practice Address - Country:US
Practice Address - Phone:703-592-6832
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-14
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701013311101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty