Provider Demographics
NPI:1407590797
Name:BARRETT, CORY MARCELL
Entity Type:Individual
Prefix:MR
First Name:CORY
Middle Name:MARCELL
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 1:11931 E NEVADA CIR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-2264
Mailing Address - Country:US
Mailing Address - Phone:303-866-7875
Mailing Address - Fax:
Practice Address - Street 1:700 POTOMAC ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011-6844
Practice Address - Country:US
Practice Address - Phone:303-521-4681
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-23
Last Update Date:2022-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health