Provider Demographics
NPI:1508909813
Name:BARRETT, SANDRA M (LPC)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:M
Last Name:BARRETT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 16TH ST SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-5630
Mailing Address - Country:US
Mailing Address - Phone:202-678-0894
Mailing Address - Fax:202-678-0894
Practice Address - Street 1:1720 MINNESOTA AVE SE
Practice Address - Street 2:# 6
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-4724
Practice Address - Country:US
Practice Address - Phone:202-210-9098
Practice Address - Fax:202-678-0894
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2010-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPRC 374101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC119896Medicaid
DC22476Medicaid