Provider Demographics
NPI:1407549678
Name:BARRETT, BRYCE (APC)
Entity Type:Individual
Prefix:
First Name:BRYCE
Middle Name:
Last Name:BARRETT
Suffix:
Gender:F
Credentials:APC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:187 TOWERVIEW CIR
Mailing Address - Street 2:
Mailing Address - City:MOUNT AIRY
Mailing Address - State:GA
Mailing Address - Zip Code:30563-3871
Mailing Address - Country:US
Mailing Address - Phone:706-949-1744
Mailing Address - Fax:
Practice Address - Street 1:4080 MCGINNIS FERRY RD STE 302
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-1737
Practice Address - Country:US
Practice Address - Phone:470-206-0171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-01
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC008535101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor