Provider Demographics
NPI:1629237375
Name:BARATT, MARTHA T (LCSW)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:T
Last Name:BARATT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 BAKER LN
Mailing Address - Street 2:
Mailing Address - City:EAST HADDAM
Mailing Address - State:CT
Mailing Address - Zip Code:06423-1734
Mailing Address - Country:US
Mailing Address - Phone:860-345-1090
Mailing Address - Fax:
Practice Address - Street 1:1588 SAYBROOK RD
Practice Address - Street 2:
Practice Address - City:HADDAM
Practice Address - State:CT
Practice Address - Zip Code:06438-1318
Practice Address - Country:US
Practice Address - Phone:860-345-1090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-07
Last Update Date:2008-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0039791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical