Provider Demographics
NPI:1518528629
Name:BARRETT, AMY (MA, LPC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:
Last Name:BARRETT
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4161 WILD SONNET TRL
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CORNERS
Mailing Address - State:GA
Mailing Address - Zip Code:30092-2191
Mailing Address - Country:US
Mailing Address - Phone:770-712-8192
Mailing Address - Fax:
Practice Address - Street 1:4725 PEACHTREE CORNERS CIR STE 185
Practice Address - Street 2:
Practice Address - City:PEACHTREE CORNERS
Practice Address - State:GA
Practice Address - Zip Code:30092-2553
Practice Address - Country:US
Practice Address - Phone:770-712-8192
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-28
Last Update Date:2019-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0003245101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional