Provider Demographics
NPI:1518144781
Name:BARRETT, SEANA M (MED)
Entity Type:Individual
Prefix:
First Name:SEANA
Middle Name:M
Last Name:BARRETT
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 TRUMAN PKWY
Mailing Address - Street 2:
Mailing Address - City:HYDE PARK
Mailing Address - State:MA
Mailing Address - Zip Code:02136-3663
Mailing Address - Country:US
Mailing Address - Phone:781-916-3738
Mailing Address - Fax:
Practice Address - Street 1:605 TRUMAN PKWY
Practice Address - Street 2:
Practice Address - City:HYDE PARK
Practice Address - State:MA
Practice Address - Zip Code:02136-3663
Practice Address - Country:US
Practice Address - Phone:781-916-3738
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-30
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAM18708OtherBLUE CROSS OF MASS
MA685661OtherTUFTS
MA1312677Medicaid
MAM20807Medicare UPIN