Provider Demographics
NPI:1619439130
Name:BARRETT, KAMESHA L (MS, LCADC)
Entity Type:Individual
Prefix:
First Name:KAMESHA
Middle Name:L
Last Name:BARRETT
Suffix:
Gender:F
Credentials:MS, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2717 E 93RD ST APT 310
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74137-4608
Mailing Address - Country:US
Mailing Address - Phone:708-606-2083
Mailing Address - Fax:
Practice Address - Street 1:2717 E 93RD ST APT 310
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74137-4608
Practice Address - Country:US
Practice Address - Phone:708-606-2083
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-03
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator