Provider Demographics
NPI:1407426133
Name:BARRETT, PATRICK (PHD)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:
Last Name:BARRETT
Suffix:
Gender:M
Credentials:PHD
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 428
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:IA
Mailing Address - Zip Code:52556-0008
Mailing Address - Country:US
Mailing Address - Phone:828-265-1008
Mailing Address - Fax:
Practice Address - Street 1:1760 OBSERVATORY DR STE 500
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:IA
Practice Address - Zip Code:52556-9032
Practice Address - Country:US
Practice Address - Phone:828-265-1008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-25
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2499103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical