Provider Demographics
NPI:1609157486
Name:BARRETT, KATHLEEN GIBLIN (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:GIBLIN
Last Name:BARRETT
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:MS
Other - First Name:KATE
Other - Middle Name:
Other - Last Name:BARRETT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW, LCSW
Mailing Address - Street 1:4900 W MARSHALL ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230-3105
Mailing Address - Country:US
Mailing Address - Phone:804-278-5033
Mailing Address - Fax:804-278-5033
Practice Address - Street 1:4900 W MARSHALL ST
Practice Address - Street 2:SUITE 100
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-3105
Practice Address - Country:US
Practice Address - Phone:804-278-5033
Practice Address - Fax:804-278-5033
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-07
Last Update Date:2011-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040027101041C0700X
NCC0033021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical