Provider Demographics
NPI:1417400847
Name:BARRETT, MARY (LPC, LCPC, LCPAT)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:
Last Name:BARRETT
Suffix:
Gender:F
Credentials:LPC, LCPC, LCPAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 N IRVING ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22201-1049
Mailing Address - Country:US
Mailing Address - Phone:703-628-2749
Mailing Address - Fax:
Practice Address - Street 1:215 N IRVING ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22201-1049
Practice Address - Country:US
Practice Address - Phone:703-628-2749
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-02
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPRC14982101YM0800X, 101YP2500X, 221700000X
VA0701008027101YM0800X, 221700000X, 101YP2500X
MDLC7670101YM0800X, 101YP1600X, 101YP2500X
MDATG216221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist